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1. Clinical, Demographic, and Radiological Characteristics of Patients Demonstrating Antibodies Against Myelin Oligodendrocyte Glycoprotein

Author

Sümeyye Koç, Sedat Şen, Yüksel Terzi, Ferah Kızılay, Serkan Demir, Dürdane Bekar Aksoy, Fatma Kurtuluş, Nuray Bilge, Egemen Idilman, Cihat Uzunköprü, Serdal Güngör, Vedat Çilingir, Özlem Ethemoğlu, Cavit Boz, Haluk Gümüş, Ahmet Kasım Kılıç, Ayşin Kısabay, Levent Sinan Bir, Ömer Faruk Turan, Aysun Soysal, Mesrure Köseoğlu, Gülnur Tekgöl Uzuner, Hasan Bayındır, Sibel Canbaz Kabay, Mustafa Çam, Vildan Yayla, Hüseyin Tan, Abdülcemal Özcan, Özlem Taşkapıoğlu, Muammer Korkmaz, Yusuf Tamam, Yılmaz İnanç, Hüsnü Efendi, Dilcan Kotan, Mehmet Fatih Yetkin, Adnan Burak Bilgiç, Hikmet Saçmacı, Serpil Demirci, Yahya Çelik, Turan Poyraz, and Murat Terzi

Subjects
Medicine
Abstract

Background: Optic neuritis, myelitis, and neuromyelitis optica spectrum disorder (NMOSD) have been associated with antibodies against myelin oligodendrocyte glycoprotein-immunoglobulin G (anti-MOG-IgG). Furthermore, patients with radiological and demographic features atypical for multiple sclerosis (MS) with optic neuritis and myelitis also demonstrate antibodies against aquaporin-4 and anti-MOG-IgG. However, data on the diagnosis, treatment, follow-up, and prognosis in patients with anti-MOG-IgG are limited. Aims: To evaluate the clinical, radiological, and demographic characteristics of patients with anti-MOG-IgG. Study Design: Multicenter, retrospective, observational study. Methods: Patients with blood samples demonstrating anti-MOG-IgG that had been evaluated at the Neuroimmunology laboratory at Ondokuz Mayıs University’s Faculty of Medicine were included in the study. Results: Of the 104 patients with anti-MOG-IgG, 56.7% were women and 43.3% were men. Approximately 2.4% of the patients were diagnosed with MS, 15.8% with acute disseminated encephalomyelitis (ADEM), 39.4% with NMOSD, 31.3% with isolated optic neuritis, and 11.1% with isolated myelitis. Approximately 53.1% of patients with spinal involvement at clinical onset demonstrated a clinical course of NMOSD. Thereafter, 8.8% of these patients demonstrated a clinical course similar to MS and ADEM, and 28.1% demonstrated a clinical course of isolated myelitis. The response to acute attack treatment was lower and the disability was higher in patients aged > 40 years than patients aged < 40 years at clinical onset. Oligoclonal band was detected in 15.5% of the patients. Conclusion: For patients with NMOSD and without anti-NMO antibodies, the diagnosis is supported by the presence of anti-MOG-IgG. Furthermore, advanced age at clinical onset, Expanded Disability Status Scale (EDSS) score at clinical onset, spinal cord involvement, and number of attacks may be negative prognostic factors in patients with anti-MOG-IgG.

Published
2024
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2. Prognostic Value of CXCL13, CCL11, and CCL20 Chemokines in Multiple Sclerosis

Author

Işıl Peker, Hacer Eroğlu İçli, Belgin Mutluay, Burcu Yüksel, Zeynep Özdemir, Mesrure Köseoğlu, Aysu Şen, Dilek Ataklı, Aysun Soysal, and Musa Öztürk

Subjects
relapsing–remitting multiple sclerosis, B lymphocyte chemoattractant molecule, eotaxin-1, macrophage inflammatory protein 3-alfa, biomarkers, Biology (General), QH301-705.5
Abstract

Objective: The course of relapsing–remitting multiple sclerosis (RRMS) is highly variable and there is a lack of effective prognostic biomarkers. This study aimed to assess the potential prognostic value of the chemokines B lymphocyte chemoattractant molecule (CXCL13), eotaxin-1 (CCL11), and macrophage inflammatory protein 3-alpha (CCL20) in RRMS. Methods: Forty-two patients with MS were enrolled, along with 22 controls, 12 of the controls were idiopathic intracranial hypertension (IIH) patients, and 10 of the controls were other neurologic diseases (OND). Chemokine levels were measured using enzyme-linked immunosorbent assay (ELISA) in serum and cerebrospinal fluid (CSF) samples. Results: No significant differences were observed among the groups in serum levels of CXCL13, CCL11, and CCL20 (p = 0.509, p = 0.979, p = 0.169, respectively). CSF CXCL13 levels were significantly higher in the OND group (p = 0.016). A PATH analysis showed CSF CXCL13 was significantly associated with new T2 hyperintense lesions on brain magnetic resonance imaging (p < 0.001), and baseline serum CCL11 levels were associated with EDSS (p = 0.030), implying its potential role in indicating neurodegenerative processes and possible progression risk. Serum CCL20 correlated with EDSS (p = 0.002) and lesion burden (p < 0.001), reflecting disease severity. Conclusions: These findings suggest that CSF CXCL13 could serve as a useful biomarker for predicting active disease in RRMS, while follow-up serum CCL11 may assist in identifying progression. Although these chemokines are not specific to MS, higher levels may signal disease activity, severity, and transition to more progressive stages.

Published
2024
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3. Could Serum Endocan Be a Vascular Endothelial Marker in Relapsing-Remitting Multiple Sclerosis?

Author

Arife Çimen Atalar, Mesrure Köseoğlu, Nurettin Yavuz, Yüksel Erdal, Osman Oğuz, and Ufuk Emre

Subjects
endocan, esm-1, multiple sclerosis, biomarker, inflammation, Medicine, Neurology. Diseases of the nervous system, RC346-429
Abstract

Objective: Multiple sclerosis (MS) is a chronic degenerative and inflammatory disease leading to axonal damage and demyelination in the central nervous system. Although the pathogenesis is still controversial, it is accepted that there is an immune-mediated inflammatory response. Endothelial cell specific molecule-1 (ESM-1) (endocan) is expressed by endothelial cells under the control of cytokines, and increases in inflammatory processes involving the vascular endothelium. In this study, we aimed to compare serum endocan levels along with other hematologic inflammatory markers [such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)] in patients with relapsing-remitting MS (RRMS) and healthy controls. We also aimed at investigating the role of vascular endothelial dysfunction in RRMS. Materials and Methods: We enrolled 64 patients with RRMS in the remission period, and 37 healthy controls in the study. We investigated hematologic parameters (ESR, CRP) and serum ESM-1 levels by enzyme-linked immunosorbent assay. Results were compared between two groups statistically. Results: The CRP and ESR had no significant difference between patients and controls (p=0.861 and p=0.76 respectively). Serum endocan levels of the patient group were significantly higher than the healthy controls (p=0.045). RRMS patients with or without treatment and comorbid diseases showed no significant difference in serum endocan levels (p=0.565 and p=0.169 respectively). The predictive value of endocan was 62.0%, cut-off value was 9124.7326 pg/l, sensitivity was 68.8%, and specificity was 54.1%. Conclusion: We demonstrated higher serum endocan levels in patients with RRMS in remission period, confirming the role of vascular inflammation. Further studies including larger patient cohorts are needed to support our results.

Published
2021
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4. Prevalance and Clinical Characteristics of Pain in Patients with Obstructive Sleep Apnea Syndrome

Author

Mesrure Köseoğlu, Serkan Özben, Bahar Erbaş, Gökçen Gözübatık Çelik, Vasfiye Kabeloğlu, and Dilek Ataklı

Subjects
obstructive sleep apnea syndrome, pain, depression, fatigue, Medicine, Medicine (General), R5-920
Abstract

Objective:It has been shown that pain, depression, and fatigue related to Obstructive Sleep Apnea syndrome (OSAS) results in a significant socioeconomic burden. We aimed to determine the prevalence, demographic, and clinical properties of pain symptoms in OSAS patients.Materials and Methods:We evaluated 84 OSAS patients diagnosed after full-night polysomnography with the Brief Pain Inventory, Beck Depression Rating scale (BDS), Pittsburg Sleep Quality index (PSQI), Epworth Sleepiness scale (ESS), Fatigue Impact scale (FIS), and Fatigue Severity scale (FSS).Results:A total of 84 patients (62 males, 22 females) with a mean age of 54.37±11.03 years were included. Headache in 25 (43.1%), myofascial pain in 22 (37.9%), and other types of pain in 11 patients were defined. ESS, FSS, FIS total, physical, cognitive, and psychosocial scores were found to be significantly higher in patients with pain. The presence of pain did not differ according to the severity of OSAS, and no significant difference was found in any parameters between mild, moderate, and severe OSAS except for minimal O2 saturation. A positive correlation between last week pain severity and BDS scores, a negative correlation between PSQI scores and the decrease in pain rate as a result of the treatment, and a weak positive correlation between FIS-cognitive sub-score and pain intensity scores were found.Conclusion:In our study, excessive daytime sleepiness and the impact and severity of fatigue were found to be higher in patients with pain than in those without pain. The most obvious difference was seen in terms of cognitive, and psychosocial fatigue. Contrary to expectations, it was observed that OSAS severity did not affect pain according to our data.

Published
2020
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5. The Prevalence of Alternative-complementary Therapies in Patients with Multiple Sclerosis

Author

Rabia Gökçen Gözübatık Çelik, Musa Öztürk, Serap Altın, Mesrure Köseoğlu, Hande Sariahmetoğlu, Mesude Tütüncü, and Aysun Soysal

Subjects
Multiple sclerosis treatment, alternative medicine, complementary medicine, Medicine, Neurology. Diseases of the nervous system, RC346-429
Abstract

Objective: Multiple sclerosis (MS) is a chronic demyelinating/degenerative disease of the central nervous system that causes disability in young adults. Complementary medicine (CM) and alternative medicine (AM) as a concept is outside the scope of traditional medicine and generally includes all diagnostic and treatment methods for which scientific data are insufficient. Facilitating access to alternative-complementary therapies makes their use widespread. The aim of this study was to evaluate the knowledge level of patients with MS by using a questionnaire and the knowledge of the perception of AM. Materials and Methods: Patients who were definitively diagnosed as having MS-clinically isolated syndrome in the clinic of our hospital were included on a voluntary basis. Sociodemographic characteristics, type of MS, date of diagnosis, number of attacks, and MS disability scale were recorded. The questionnaire, which was prepared for alternative or complementary therapies used, was completed by the same researcher. Data were analysed using SPSS 21 program Results: Two hundred ten patients with MS were included in our study. It was determined that all patients were aware of AM/CM treatments, the highest rate of information was obtained from the internet (76%), 1.4% AM, 49% CM was used. Ninety-seven % of the patients received TT for the purpose of relieving their symptoms (p≤0.005). Mostly garlic (83.4%), caper (79.6%), ginger (69.9%), and goat’s milk (60%) was used. CM was statistically significantly higher in the first decade (p≤0.005). It was observed that 32% of the patients used TT after the 2nd MS attack without any significance. Conclusion: Our study showed that patients with MS used CM temporarily and with high rates. In contrast to the literature, the rate of use in the first period of the disease was found to be significantly higher. This condition was interpreted as the fact that at the beginning of the disease it could be made with the hope of fighting MS and fully recovering, but after the understanding of the nature of the disease, the use of AM/CM decreased.

Published
2019
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6. The Investigation of the Effect of Continuous Positive Airway Pressure Treatment on Metabolic Syndrome and Insuline Resistance in Obstructive Sleep Apnea Syndrome Patients

Author

Vasfiye İlbay, Mesrure Köseoğlu Bitnel, Oya Öztürk, Nermin Görkem Şirin İnan, Yeşim Kaykı, Mehmet İlbay, Hayrunisa Dilek Ataklı, and Aysun Soysal

Subjects
Obstructive sleep apnea syndrome, insulin resistance, continuous positive airway pressure, metabolic syndrome, Medicine, Medicine (General), R5-920
Abstract

Objective: To evaluate the effect of continuous positive airway pressure (CPAP) treatment on metabolic syndrome and insuline resistance in patients with obstructive sleep apnea syndrome (OSAS). Materials and Methods: This study evaluated retrospectively with 30 patients who received OSAS diagnosis following polysomnography between the years January 2016 - January 2017, whose Respiratory Disturbance Index were above 15, and who were between the ages of 18-78, having no diabetes, chronic liver and kidney disease, malignancy and mental retardation. The anthropometric measures and blood values of these patients before the CPAP treatment and 3 months afterwards were evaluated in their controls. The effect of CPAP treatment on metabolic syndrome and insulin resistance assessed by homeostatic model assessment index was investigated. Results: It has been observed that the body mass index (BMI) decreases significantly following the CPAP treatment. No significant changes were found in the anthropometric measurements including the neck circumference, waist circumference, hip circumference, and waist/hip ratios as well as insulin resistance and metabolic syndrome parameters (before of treatment BMI: 31.33±5.58, post treatment BMI: 30.83±7.13, p=0.03). The ESS evaluating the subjective daytime sleepiness following the CPAP treatment has decreased significantly. Conclusion: Although this study didn’t improve insulin resistance with assessed homeostatic model assessment, and metabolic syndrome, a significant improvement in BMI and ESS was demonstrated in post treatment. Long-term studies with more cases and with high compliance are needed to demonstrate the effects of CPAP treatment on metabolic syndrome in OSAS patients.

Published
2017
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7. Retrospective analysis of effectiveness of fingolimod in real life setting in Turkey (REFINE)

Author

MERYEM ASLI TUNCER, MURAT KÜRTÜNCÜ, MURAT TERZİ, UĞUR UYGUNOĞLU, CANSU GÖNCÜOĞLU, AYŞE NUR YÜCEYAR, ÖZGÜL EKMEKCİ, RECAİ TÜRKOĞLU, AYSUN SOYSAL, MESRURE KÖSEOĞLU, CAVİT BOZ, YEŞİM BECKMANN, ÖMER FARUK TURAN, DURUHAN MELTEM DEMİRKIRAN, and FİRDEVS GÜLŞEN AKMAN

Subjects
Fingolimod, Glatiramer Acetate, Treatment Switch, General Medicine, Beta Interferon, Disease Modifying Treatment
Abstract

Background/aim: During multiple sclerosis (MS) treatment different modes of action such as lateral (interferon beta to glatiramer acetate or glatiramer acetate to interferon beta) or vertical (interferon beta/glatiramer acetate to fingolimod) drug switch can be performed. This study aims to investigate the clinical effectiveness of switching from the first-line injectable disease modifying treatments (iDMTs) to fingolimod (FNG) compared to switching between first-line iDMTs. Materials and methods: This is a multicenter, observational and retrospective study of patients with relapsing-remitting MS who had lateral and vertical switch. The observation period included three key assessment time points (before the switch, at switch, and after the switch). Data were collected from the MS patients’ database by neurologists between January 2018 and June 2019. The longest follow-up period of the patients was determined as 24 months after the switch. Results: In 462 MS patients that were included in the study, both treatments significantly decreased the number of relapses during the postswitch 12 months versus preswitch one year while patients in the FNG group experienced significantly fewer relapses compared to iDMT cohort in the postswitch 12 months period. FNG cohort experienced fewer relapses than in the iDMT cohort within the postswitch 2 year. The mean time to first relapse after the switch was significantly longer in the FNG group. Conclusion: The present study revealed superior effectiveness of vertical switch over lateral switch regarding the improvement in relapse outcomes. Patients in the FNG cohort experienced sustainably fewer relapses during the follow-up period after the switch compared the iDMT cohort. Importantly, switching to FNG was more effective in delaying time to first relapse when compared with iDMTs.

Published
2023
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8. mRNA versus inactivated virus COVID-19 vaccines in multiple sclerosis: Humoral responses and protectivity—Does it matter?

Author

Melih Tütüncü, Serkan Demir, Gökhan Arslan, Öykü Dinç, Sedat Şen, Tuncay Gündüz, Cihat Uzunköprü, Haluk Gümüş, Mesude Tütüncü, Rüveyda Akçin, Serkan Özakbaş, Mesrure Köseoğlu, Sena Destan Bünül, Ozan Gezen, Damla Çetinkaya Tezer, Cavid Baba, Pınar Acar Özen, Rabia Koç, Tuğrul Elverdi, Uğur Uygunoğlu, Murat Kürtüncü, Yeşim Beckmann, İpek Güngör Doğan, Ömer Faruk Turan, Cavit Boz, Murat Terzi, Asli Tuncer, Sabahattin Saip, Rana Karabudak, Bekir Kocazeybek, Hüsnü Efendi, Uğur Bilge, and Aksel Siva

Subjects
Neurology, Neurology (clinical), General Medicine
Abstract

Background: COVID-19 vaccines are recommended for people with multiple sclerosis (pwMS). Adequate humoral responses are obtained in pwMS receiving disease-modifying therapies (DMTs) after vaccination, with the exception of those receiving B-cell-depleting therapies and non-selective S1P modulators. However, most of the reported studies on the immunity of COVID-19 vaccinations have included mRNA vaccines, and information on inactivated virus vaccine responses, long-term protectivity, and comparative studies with mRNA vaccines are very limited. Here, we aimed to investigate the association between humoral vaccine responses and COVID-19 infection outcomes following mRNA and inactivated virus vaccines in a large national cohort of pwMS receiving DMTs. Methods: This is a cross-sectional and prospective multicenter study on COVID-19-vaccinated pwMS. Blood samples of pwMS with or without DMTs and healthy controls were collected after two doses of inactivated virus (Sinovac) or mRNA (Pfizer-BioNTech) vaccines. PwMS were sub-grouped according to the mode of action of the DMTs that they were receiving. SARS-CoV-2 IgG titers were evaluated by chemiluminescent microparticle immunoassay. A representative sample of this study cohort was followed up for a year. COVID-19 infection status and clinical outcomes were compared between the mRNA and inactivated virus groups as well as among pwMS subgroups. Results: A total of 1484 pwMS (1387 treated, 97 untreated) and 185 healthy controls were included in the analyses (male/female: 544/1125). Of those, 852 (51.05%) received BioNTech, and 817 (48.95%) received Sinovac. mRNA and inactivated virus vaccines result in similar seropositivity; however, the BioNTech vaccination group had significantly higher antibody titers (7.175±10.074) compared with the Sinovac vaccination group (823±1.774) (p

Published
2023

10. Sexual dysfunction and associated risk factors in multiple sclerosis

Author

Dilek Atakli, Rabia Gökçen Gözübatik Çelik, Duygu Deringol, Mesrure Köseoğlu, Mesude Tutuncu, Bahar Erbaş, and Ayhan Bingol

Subjects
Gynecology, medicine.medical_specialty, Medicine (General), RD1-811, business.industry, seksüel disfonksiyon, multiple sclerosis, multipl skleroz, R5-920, depresyon, sexual dysfunction, kognitif bozukluk, depression, medicine, Medicine, Surgery, business, cognitive impairment
Abstract

Amac: Cinsel islev bozuklugu (CIB), multipl sklerozda (MS) sik gorulen multifaktoryel bir durumdur. Bu calisma, MS’de CIB sikligini degerlendirmek ve ilgili faktorleri arastirmak amaciyla duzenlenmistir. Yontemler: Kesitsel ozellikteki bu calismaya, 2018-2019 yillarinda,18 ile 60 yaslari arasinda Mc Donald kriterlerine gore kesin relapsing remitting multipl skleroz (RRMS) tanisi alan 96 hasta gonullu olarak calismaya dahil edildi. Multiple sclerosis intimacy and sexuality questionnaire-19 (MSISQ-19), Arizona Sexual Experience Scale (ASEX), Multiple Sclerosis Inventory of Cognition (MUSIC) ve Beck Depresyon Olcegi (BDI) anketleri uygulandi. Bulgular: Hastalarin yas ortalamasi 38,46 (8,47) (min-maks: 20 - 60 yil) yildi; ortalama hastalik suresi 77,02 (70,62) (3 - 324 ay) aydi. Ortalama Genisletilmis Ozurluluk Durumu Olcegi (EDSS) puani 2,1 (1,33) (0-5) ve standart sapma %80,5 idi. MUZIK bilissel puani ile EDSS puani (P=0,017; r=-0,273) ve MUZIK bilissel ve BDO puani arasinda (P=0,003; r=-0,306) negatif bir korelasyon goruldu. Muzik yorgunluk testi sonuclarinda MSISQ skoru (P

Published
2020

11. Quality of Life in Multiple Sclerosis: Are Depressive Findings as Effective as Physical Disability?

Author

Mesrure Köseoğlu, Rabia Gökçen Gözübatık Çelik, Mesude Özerden Tütüncü, and Bahar Erbaş

Subjects
lcsh:R5-920, depresyon, lcsh:R, lcsh:Medicine, edss, yorgunluk, yaşam kalitesi, lcsh:Medicine (General), multipl skleroz
Abstract

Amaç: Multipl Sklerozda (MS) yaşam kalitesinin bozulması tedavi uyumunu ve klinik takibi güçleştirir. Çalışmamızda hastaların yaşam kalitesine etki eden faktörlerden fiziksel nedenler ile psikolojik olarak en fazla gözlenen depresif bulgular arasında karşılaştırma yaparak, bu konunun önemini vurgulamayı amaçladık. Yöntemler: Mc Donalds kriterlerine göre relapsing-remitting tanısı almış 100 hasta çalışmaya dahil edildi. Sosyodemografik özellikleri, hastalık başlangıç yaşları, hastalık süreleri, özürlülük düzeyleri, Beck Depresyon Ölçeği, Yorgunluk Şiddet Ölçeği ve Kısa Form Yaşam Kalitesi Ölçeği skorları kaydedildi. Bulgular: 65’i kadın, 35’i erkek 100 hastanın yaş ortalaması 35,21 ± 8,86 (min-max:18-63) yıldı. Ortalama Krutzke Genişletilmiş Dizabilite Durum Skalası (EDSS) skorları 1,65 ± 1,47 (min-max:0-6,5) olarak kaydedildi. Beck Depresyon Ölçeği skorları kadınlarda erkeklere göre daha yüksek gözlendi (13,8 ± 11,02 vs 10,17 ± 6,15; p:0,036). Depresyonu olan hastaların depresyonu olmayanlara göre; yorgunluk şiddet ve yorgunluk etki ölçeği skor ortalamaları daha yüksekken, yaşam kalitesi ölçeği skorları daha düşük izlendi (p

Published
2020

12. Prevalance and Clinical Characteristics of Pain in Patients with Obstructive Sleep Apnea Syndrome

Author

Bahar Erbaş, Vasfiye Kabeloğlu, Dilek Atakli, R. Gökçen Gözübatik Çelik, Serkan Ozben, and Mesrure Köseoğlu

Subjects
lcsh:R5-920, depression, lcsh:R, lcsh:Medicine, obstructive sleep apnea syndrome, pain, fatigue, lcsh:Medicine (General)
Abstract

Objective:It has been shown that pain, depression, and fatigue related to Obstructive Sleep Apnea syndrome (OSAS) results in a significant socioeconomic burden. We aimed to determine the prevalence, demographic, and clinical properties of pain symptoms in OSAS patients.Materials and Methods:We evaluated 84 OSAS patients diagnosed after full-night polysomnography with the Brief Pain Inventory, Beck Depression Rating scale (BDS), Pittsburg Sleep Quality index (PSQI), Epworth Sleepiness scale (ESS), Fatigue Impact scale (FIS), and Fatigue Severity scale (FSS).Results:A total of 84 patients (62 males, 22 females) with a mean age of 54.37±11.03 years were included. Headache in 25 (43.1%), myofascial pain in 22 (37.9%), and other types of pain in 11 patients were defined. ESS, FSS, FIS total, physical, cognitive, and psychosocial scores were found to be significantly higher in patients with pain. The presence of pain did not differ according to the severity of OSAS, and no significant difference was found in any parameters between mild, moderate, and severe OSAS except for minimal O2 saturation. A positive correlation between last week pain severity and BDS scores, a negative correlation between PSQI scores and the decrease in pain rate as a result of the treatment, and a weak positive correlation between FIS-cognitive sub-score and pain intensity scores were found.Conclusion:In our study, excessive daytime sleepiness and the impact and severity of fatigue were found to be higher in patients with pain than in those without pain. The most obvious difference was seen in terms of cognitive, and psychosocial fatigue. Contrary to expectations, it was observed that OSAS severity did not affect pain according to our data.

Published
2020

13. Multipl Skleroz Hastalarında Metilprednizolon ve İnterferon Tedavisinin Kan Vitamin B12, Folik Asid ve Homosistein Düzeyleri Üzerine Etkisi

Author

Mesrure KÖSEOĞLU, İpek MİDİ, Tülay ÇEVLİK, Serkan ÖZBEN, Goncagül HAKLAR, and Dilek GÜNAL

Subjects
homosistein, folic acid, lcsh:R5-920, interferon-β, metilprednizolon, vitamin B12, homocysteine, multiple sclerosis, interferon-beta, lcsh:Medicine (General), folik asit, methylprednisolone, multipl skleroz
Abstract

Multipl Skleroz (MS) hastalığının seyrinde ve tedavi sürecinde homosistein, vitamin B12 ve folik asit düzeylerindeki değişiklikler bildirilmiş ancak tam mekanizması aydınlatılamamıştır. Çalışmamızda, akut atak ile başvuran hastalarda yüksek doz metilprednizolon tedavisi öncesinde, sonrasında ve interferon-β tedavisi sonrasında serum B12, folik asit ve homosisitein düzeylerindeki değişiklikler incelenmiştir. Çalışmaya 1 yıl içinde akut atak ile başvuran, klinik kesin MS tanısı konarak takip edilen 31 hasta (8 erkek, 23 kadın) ve 10 kontrol olgusu dahil edildi. 20 hasta akut atak ile başvurdu 7 gün süreyle 1000 mg/gün metilprednizolon uygulandı. 27 hastaya interferon-β tedavisi başlandı. Yüksek doz steroid tedavi sonrası 1. ay düzeyleri ve interferon-β tedavisi alan hastaların 3. ay sonundaki serum vitamin B12, folik asit ve plazma homosistein düzeyleri ölçülerek kontrol grubu ve tedavisi öncesi düzeyleri ile karşılaştırıldı. Kontrol grubuna göre MS hastalarının bazal B12 değerleri daha önceki bulgularla tutarlı olarak daha düşüktü. Hem metilprednizolon, hem de interferon-β tedavisi sonrası B12 ve folik asid değerlerinde yükselme saptandı ancak sadece metilprednizolon tedavisi sonrasındaki artış istatiksel olarak anlamlıydı. Çalışmamızda saptanan metilprednizolon sonrası yükselen B12 ve folik asid düzeyleri ve istatistiksel anlamlılığa ulaşmayan homosistein düzeylerindeki düşme eğilimi farklı tartışmalar yaratmaktadır.

Published
2019

14. The effect of cognitive performance on self-management behavior of multiple sclerosis patients

Author

Hüsnü Efendi, Aysun Ünal, Aylin Akçalı, Bengü Altunan, Ayhan Bingöl, Burcu Altunrende, Mesrure Köseoğlu, Duygu Deringöl, Cihat Uzunköprü, Cansu Eğilmez, Fatma Belgin Balcı, Gülşen Akman, Kübra Gizem Tarhan, Aslı Aksoy Gündoğdu, Simge Ertürk, and Yeşim Beckmann

Subjects
Adult, Male, Cognition, Multiple Sclerosis, Neurology, Self-Management, Humans, Female, Neurology (clinical), General Medicine, Cognition Disorders, Fatigue
Abstract

Difficulties of self-management in people with MS (pwMS) is considered as one of the most important factors contributing to low rehabilitation efficacy, more severe long-term complications and increase in healthcare costs. Despite the emergence of research in the last decade documenting causes, types, and course of cognitive difficulties in MS disease subtypes, limited evidence is available in the literature for direct comparison of self-management and cognitive deficits. In this study we aimed to investigate the relationship between cognitive performance and self-management in pwMS.PwMS who applied to neurology out-patient clinics of seven different centers were included into study. Multiple Sclerosis Self-Management Scale- Revised (MSSM-R) was used for the assessment of self-management behaviors and Multiple Sclerosis inventory cognition scale (MUSIC) was used for the assessment of cognitive performance and fatigue.In this study, 194 (144 female and 50 male) pwMS participated (mean age = 38.9 years). The course of the disease was RRMS in 173 patients and mean EDSS was 2.0. 68.5% of the participants were married, 32.5% were employed, and 57.2% had secondary education. The MSSM-R mean score of the study group was 42.6 ± 10.4 (1-81). There was a positive correlation between MSSM-R and MUSIC-cog scores (r = 0.21, p = 0.003). A hierarchical multiple regression revealed that income level (β = 0.196, t = 2.692, p = 0.008) and cognitive performance (β = 0.167, t = 2.063, p = 0.041) together with control variables (gender, age, educational status, employment status, duration of disease, EDSS and fatigue) explained 5.5% of the variance in self-management.Cognitive performance is a predictor of self-management in pwMS. Better self-management behavior is also related with employment and income level in pwMS. Studies evaluating patients' cognitive abilities and evaluating the effectiveness of adapted self-management training programs are needed.

Published
2022
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15. Multiple Sclerosis and Epilepsy

Author

Rabia Gökçen Gözübatik Çelik and Mesrure Köseoğlu

Subjects
Epilepsi,multipl skleroz,rekürren nöbet,risk faktörleri, business.industry, Epilepsy,multiple sclerosis,recurrent seizure,risk factors, Clinical Neurology, Medicine, General Medicine, business, Klinik Nöroloji
Abstract

Amaç: Epilepsi nöbeti Multipl Skleroz’un (MS) nadir bir prezentasyonudur. Bu çalışmada nöbetlerin MS’in seyri ile olan ilişkilerini, rekürren nöbetleri tetikleyebilecek faktörleri, status epileptikus prevelansını ve buna bağlı olarak epilepsi tedavisini başlama yada sürdürmedeki öngörümüzün oluşmasını amaçladık.Yöntem: MS tanılı 995 hastadan epilepsi nöbeti geçiren 56’sı çalışmaya dahil edildi.Hastaların sosyodemografik verileri, hastalık süresi, MS atak sıklığı, nöbet sıklığı, elektroensefalografi bulguları, EDSS skorları Microsoft Office Excel'e kaydedildi.Bulgular: Hastaların çoğu [%68’i (n:38)] kadındı. Ortalama yaş 28±10,5yıldı (min-max:18-61yıl). MS’in ilk atağı nöbet olan hasta 5 (%9) kişi idi. MS tipi ile nöbet varlığı açısından bir fark izlenmedi (p>0,05). Nöbet tipleri ile ortalama EDSS skoru ve MS atak sıklığı açısından karşılaştırıldığında anlamlı bir sonuca varılmadı (p>0,05). 56 hastanın %63’inde (n:35) rekürren nöbetler izlendi. 21 kişi ise 4 yıl boyunca tekrar nöbeti olmadı. Rekürren nöbet açısından CIS/RRMS olma ve ailede epilepsi öyküsü rekürren nöbetler için risk faktörleriydi (p, Objective: Seizure is a rare presentation of Multiple Sclerosis (MS) patients. We aimed to establish the relationship between seizures and the course of MS, the factors that may trigger recurrent seizures, the prevalence of status epilepticus, and accordingly, our prediction to start or continue epilepsy treatment.Methods: Fifty-six of 995 MS patients who had epileptic seizures were included. Sociodemographic data, disease duration, MS attack frequency, seizure frequency, electroencephalography, EDSS scores were recorded in Microsoft Office Excel.Results: Most of the patients [68% (n:38)] were women. The mean age was 28 ± 10.5 years (min-max: 18-61 years). In 5 patients (9%), seizure had a first MS attack. There was no difference between MS type and seizure (p>0.05). No significant result was obtained when the types of seizures were compared in terms of mean EDSS score and MS attack frequency (p>0.05). Recurrent seizures were observed in 63% (n: 35) of 56 patients. 21 people did not have seizures again for 4 years. In terms of recurrent seizures, being CIS / RRMS and family history of epilepsy were risk factors for recurrent seizures (p

Published
2020

16. Multipl Skleroz Hastalarında Metilprednizolon ve İnterferon Tedavisinin Kan Vitamin B12, Folik Asid ve Homosistein Düzeyleri Üzerine Etkisi

Author

Tulay Cevlik, Mesrure Köseoğlu, Goncagül Haklar, Dilek Ince Gunal, Ipek Midi, and Serkan Ozben

Subjects
medicine.medical_specialty, Homocysteine, business.industry, Multiple sclerosis, General Medicine, Homocysteine levels, multiple sclerosis,methylprednisolone,interferon-beta,vitamin B12,folic acid,homocysteine, medicine.disease, multipl skleroz,metilprednizolon,interferon-β,vitamin B12,folik asit,homosistein, Gastroenterology, chemistry.chemical_compound, chemistry, Methylprednisolone, Folic acid, Interferon, Health Care Sciences and Services, Internal medicine, Medicine, In patient, Vitamin B12, Sağlık Bilimleri ve Hizmetleri, business, medicine.drug
Abstract

Changes in blood homocysteine, vitamin B12 andfolic acid levels have been reported during multiple sclerosis (MS) andtreatment period; however, the exact mechanism has not been enlightened. We investigated the changes of serumB12, folic acid, and plasma homocysteine levels before and after high-dose IVmethylprednisolone treatment and after interferon-β treatment in patientsadmitted with an acute attack of MS.31 patients followed for clinicallydefinite MS (8 male, 23 female) and 10 control individuals were included in thestudy. 20 patients were admitted with an acute attack and were administered 1000 mg/day methylprednisolone for 7 days. 27patients started interferon-β treatment. Serum B12, folic acid, and plasmaHomocysteine levels measured before and after the 1 month after high dosesteroid treatment and after 3-month interferon-β treatment were compared withpre-treatment levels and healthy controls. Baseline B12 levels were lower in patients with MS than in healthycontrols, which is consistent with previous findings. Both methylprednisolone and interferon-β treatments increasedserum B12 and folic acid levels compared with baseline; however, only theincrease following methylprednisolone treatment was statistically significant.Inour study, elevated B12 and folic acid levels and decreasing of homocysteinelevels without reaching statistical significance following methylprednisolonehave caused different debates., Multipl Skleroz (MS) hastalığınınseyrinde ve tedavi sürecinde homosistein, vitamin B12 ve folik asitdüzeylerindeki değişiklikler bildirilmiş ancak tam mekanizmasıaydınlatılamamıştır. Çalışmamızda, akut atak ile başvuranhastalarda yüksek doz metilprednizolon tedavisi öncesinde, sonrasında ve interferon-β tedavisi sonrasındaserum B12, folik asit ve homosisitein düzeylerindeki değişikliklerincelenmiştir. Çalışmaya 1 yıl içinde akut atak ile başvuran,klinik kesin MS tanısı konarak takip edilen 31 hasta (8 erkek, 23 kadın) ve 10 kontrol olgusu dahil edildi. 20 hastaakut atak ile başvurdu 7 gün süreyle 1000 mg/gün metilprednizolon uygulandı. 27hastaya interferon-β tedavisibaşlandı. Yüksek doz steroid tedavi sonrası 1. ay düzeyleri ve interferon-β tedavisi alan hastaların 3. ay sonundaki serum vitamin B12, folik asit ve plazma homosistein düzeyleri ölçülerek kontrol grubu ve tedavisiöncesi düzeyleri ile karşılaştırıldı. Kontrol grubuna göre MS hastalarınınbazal B12 değerleri daha önceki bulgularla tutarlı olarak daha düşüktü. Hemmetilprednizolon, hem de interferon-β tedavisi sonrası B12 ve folik asid değerlerindeyükselme saptandı ancak sadece metilprednizolon tedavisi sonrasındaki artış istatikselolarak anlamlıydı. Çalışmamızda saptanan metilprednizolon sonrası yükselen B12 ve folik asid düzeylerive istatistiksel anlamlılığa ulaşmayan homosistein düzeylerindeki düşme eğilimi farklıtartışmalar yaratmaktadır.

Published
2018

17. Obstrüktif Uyku Apne Sendromu Hastalarında Devamlı Pozitif Havayolu Basıncı Tedavisinin Metabolik Sendroma ve İnsülin Direncine Etkisinin Araştırılması.

Author

İlbay, Vasfiye, Bitnel, Mesrure Köseoğlu, Öztürk, Oya, İnan, Nermin Görkem Şirin, Kaykı, Yeşim, İlbay, Mehmet, Ataklı, Hayrunisa Dilek, and Soysal, Aysun

Subjects
SLEEP apnea syndrome treatment, METABOLIC syndrome diagnosis, ANTHROPOMETRY, CIRCADIAN rhythms, DROWSINESS, HOMEOSTASIS, INSULIN resistance, SLEEP apnea syndromes, POLYSOMNOGRAPHY, BODY mass index, TREATMENT effectiveness, RETROSPECTIVE studies, CONTINUOUS positive airway pressure
Abstract

Copyright of Journal of Turkish Sleep Medicine is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2017
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18. Huzursuz Bacaklar Sendromu Hastalarında Depresyon ve Uyku Kalitesi.

Author

Tuaç, Selma Topaloğlu, Özben, Serkan, Bitnel, Mesrure Köseoğlu, and Baybaş, Sevim

Abstract

Copyright of Journal of Turkish Sleep Medicine is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2017
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19. Depression and Sleep Quality in Patients with Restless Legs Syndrome

Author

Selma Topaloglu Tuaç, Serkan Özben, Mesrure Köseoglu Bitnel, and Sevim Baybas

Subjects
Restless Legs Syndrome, Willis-Ekbom disease, depression, sleep disorder, Medicine, Medicine (General), R5-920
Abstract

Objective Restless Legs Syndrome (RLS) is a common neurological disorder that affects patients’ sleep, emotional state and daily life negatively. In this study it was aimed to determine the sleep quality, daytime sleepiness and depression frequency in patients with RLS and their relation with duration and severity of illness. Materials and Methods In our center, 41 patients with primary RLS diagnosis were included in the study. Patients were divided into groups as mild, moderate, severe and very severe, according to the RLS severity scale of the International Restless Legs Syndrome Study Group. Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Beck Depression Inventory were filled in by all the patients, including identity and sociodemographic data with illness information. Statistical analysis was performed among groups divided according to disease severity. Depressive symptoms of the disease duration and its relation with sleep problems were investigated. Results In this study 41 patients, 30 (73.2%) female, 11 (26.8%) male, were included. Of the patients participating in the study, 2 patients (4.9%) had mild RLS while 7 (17.1%) were very severely ill. Fourteen patients (34.1%) had moderate disease and 18 (43.9%) had severe disease. Bad sleep quality was found in 68.3% (n=28) of patients with RLS, excessive daytime sleepiness in 14.6% (n=6) severe depression in 7.3% (n=3) and totally 29.3% of patients (n=12) depressive symptoms were observed. As the severity of illness increased, sleep quality deteriorated and depressive symptoms increased (p

Published
2017
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