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1. Best Practice Recommendations for Geriatric Dysphagia Management with 5 Ws and 1H

Author

Ebru Umay, Sibel Eyigor, Gulistan Bahat, Meltem Halil, Esra Giray, Pelin Unsal, Zeliha Unlu, Canan Tikiz, Meltem Vural, Asli Tufan Cincin, Serkan Bengisu, Eda Gurcay, Kemal Keseroglu, Banu Aydeniz, Elif Celik Karaca, Burak Karaca, Ahmet Yalcin, Cemile Ozsurekci, Dilek Seyidoglu, Ozlem Yilmaz, Sibel Alicura, Serhat Tokgoz, Barin Selcuk, Ekin Ilke Sen, Ali Yavuz Karahan, Ayse Yaliman, Serdar Ozkok, Birkan Ilhan, Merve Guner Oytun, Zeynel Abidin Ozturk, Sibel Akin, Betul Yavuz, Mazlum Serdar Akaltun, Aylin Sari, Murat Inanir, Meral Bilgilisoy, Zuhal Çaliskan, Guleser Saylam, Tugce Ozer, Yasemin Eren, Derya Hopanci Bicakli, Dilek Keskin, Zekeriya Ulger, Aylin Demirhan, Yalkin Calik, Bulent Saka, Zeynep Aykin Yigman, and Erhan Arif Ozturk

Subjects
oropharyngeal dysphagia, esophageal dysphagia, geriatrics, consensus, diagnosis, rehabilitation, Medicine, Geriatrics, RC952-954.6
Abstract

Background Dysphagia is a geriatric syndrome. Changes in the whole body that occur with aging also affect swallowing functions and cause presbyphagia. This condition may progress to oropharyngeal and/or esophageal dysphagia in the presence of secondary causes that increase in incidence with aging. However, no study has been published that provides recommendations for use in clinical practice that addresses in detail all aspects of the management of dysphagia in geriatric individuals. This study aimed to answer almost all potential questions and problems in the management of geriatric dysphagia in clinical practice. Methods A multidisciplinary team created this recommendation guide using the seven-step and three-round modified Delphi method via e-mail. The study included 39 experts from 29 centers in 14 cities. Results Based on the 5W and 1H method, we developed 216 detailed recommendations for older adults from the perspective of different disciplines dealing with older people. Conclusion This consensus-based recommendation is a useful guide to address practical clinical questions in the diagnosis, rehabilitation, and follow-up for the management of geriatric dysphagia and also contains detailed commentary on these issues.

Published
2022
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2. One misfortune is better than thousands of pieces of advice: the warning role of rectal bleeding

Author

Yagmur Sitem Akbulut, Caner Yesiloglu, Sebnem Busra Altinkalem, Orhun Akdogan, S. Coskun Yazgan, Derya Gokmen, Ismail Calikoglu, Muzaffer Akkoca, Serhat Tokgoz, and Mehmet Ayhan Kuzu

Subjects
Colorectal cancer, rectal bleeding, colorectal polyps, adults greater than or equal to 40 years old, awareness, Surgery, RD1-811
Abstract

Objective: Rectal bleeding is one of the most important symptoms of colorectal cancer that fast-tracks the patients consultation with a physician. This study aims to assess the warning role of rectal bleeding in a risk group for colorectal cancer. Besides, the relationship among awareness, various socio-demographic criteria and the reasons for visiting or not visiting the physician was evaluated among greater than or equal to 40 years old. Methods: This descriptive study was conducted thousand one hundred and sixteen (1116) individuals greater than or equal to 40 years old. Awareness of rectal bleeding as a warning sign in participating individuals was assessed by a questionnaire in addition to their family history of cancer or polyps and reasons for visiting or not visiting a physician. Results: A prior history of rectal bleeding was found in 51.9% of subjects. Among those with rectal bleeding history, the rate of visiting a physician due to this bleeding was 49.7%. No statistically significant relationship was found between the frequency of those who contacted their physician and gender, education or age. The frequency of visiting a physician was significantly higher among individuals with a family history of colorectal cancer as compared with no family history and was directly proportional to the degree of family relationship (p = 0.007). Conclusion: Even rectal bleeding does not raise enough attention for visiting a physician. Therefore, public education and screening still have paramount importance in the prevention of colorectal cancer. [Arch Clin Exp Surg 2019; 8(1.000): 15-20]

Published
2019
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3. CT-guided tractography is a safe and complementary diagnostic tool in the management of penetrating abdominal trauma

Author

Muzaffer Akkoca, Sener Balas, Kerim Bora Yilmaz, Idil Gunes Tatar, Melih Akinci, Serhat Tokgoz, Selim Tamam, and Harun Karabacak

Subjects
Surgery, RD1-811
Abstract

Summary: Background/Objective: Despite extensive published research, the surgical approach to penetrating abdominal trauma patients is still under debate. Computed tomography-guided tractography (CTT) is an imaging modality in which water soluble iodinated contrast medium is administered into the site of the injury in the CT unit. The aim of this study was to determine the diagnostic accuracy of the CTT. Methods: A retrospective evaluation was made of patients admitted to the Emergency Department with penetrating abdominal trauma and who underwent CTT. Contrast enhanced abdominal CT and CTT reports, surgical findings and clinical results were examined. Results: Evaluation was made of a total of 101 patients comprising 89 males (88.1%) and 12 females (11.9%). CTT was determined to have 92.8% sensitivity, 93.6% specificity, 97% positive predictive value, and 85.5% negative predictive value. In 27 patients (26.7%) where the CTT indicated passage through the peritoneum, no parenchymal organ injury was present. Only one patient (2.9%) without peritoneal penetration on CTT had organ injury at exploration. No procedure-related morbidities developed. Conclusion: CTT is a safe imaging modality for the evaluation of hemodynamically stable patients. Compared to other imaging modalities, there is clearer demonstration of whether or not the peritoneum is intact. However penetration on CTT does not exactly correlate with organ injury. Keywords: Computed tomography guided tractography, Penetrating abdominal trauma, Therapeutic trauma laparotomy, Negative laparotomy

Published
2019
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4. Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

Author

Abdelhamid, N, Abdul Rahman, D, Abdul-Saheb, M, Abreu, P, Abroskina, M, Abu Ahmad, F, Accassat, S, Acciaresi, M, Adami, A, Ahmad, N, Ahmed, F, Alberto Hawkes, M, Alemseged, F, Ali, A, Altavilla, R, Alwis, L, Amarenco, P, Amaro, S, Amaya Sanchez, LE, Amelia Pinto, A, Ameriso, SF, Amin, H, Amino, T, Amjad, AK, Anagnostou, E, Andersen, G, Anderson, C, Anderson, DC, Andrea Falco, M, Andres Mackinnon, F, Andreu, D, Androulakis, M, Angel Gamero, M, Angel Saredo, G, Angeles Diaz, R, Angels Font, M, Anticoli, S, Arauz, A, Arauz Gongora, AA, Araya, P, Arenillas Lara, JF, Arias Rivas, S, Arnold, M, Augustin, S, Avelar, W, Azevedo, E, Babikian, V, Bacellar, A, Badalyan, K, Bae, HJ, Baez Martinez, EM, Bagelmann, H, Bailey, P, Bak, Z, Baker, M, Balazs, A, Baldaranov, D, Balogun, I, Balueva, T, Bankuti, Z, Bar, M, Baranowska, A, Bardutzky, J, Barker Trejo, S, Barlinn, J, Baronnet, F, Barroso, C, Barteys, M, Bartolottiova, T, Barulin, A, Bas, M, Bashir, S, Basile, V, Bathe-Peters, R, Bathula, R, Batista, C, Batur Caglayan, H, Baumgartner, P, Bazan, R, Bazhenova, O, Beaudry, M, Beer, J, Behnam, Y, Beilei, C, Beinlich, A, Bejot, Y, Belkin, A, Benavente, OR, Benjamin, A, Berardi, V, Bereczki, D, Berkowitz, SD, Berlingieri, J, Berrios, W, Berrouschot, J, Bhandari, M, Bhargavah, M, Bicker, H, Bicsak, T, Bilik, M, Bindila, D, Birchenall, J, Birnbaum, L, Black, T, Blacker, D, Blacquiere, D, Blanc-Labarre, C, Blank, C, Blazejewska-Hyzorek, B, Bloch, S, Bodiguel, E, Bogdanov, E, Boos, L, Borcsik, L, Bornstein, N, Bouly, S, Braga, G, Bragado, I, Bravi, MC, Brokalaki, C, Brola, W, Brouns, R, Bruce, D, Brzoska-Mizgalska, J, Buck, B, Buksinska-Lisik, M, Burke, J, Burn, M, Bustamante, G, Cabrejo, L, Cai, K, Cajaraville, S, Calejo, M, Calvet, D, Campillo, J, Campos Costa, E, Camps, P, Can Alaydin, H, Candeloro, E, Canepa, C, Cantu Brito, CG, Cappellari, M, Carcel, C, Cardona Portela, P, Cardoso, F, Carek, M, Carletti, M, Carlos Portilla, J, Caruso, P, Casado-Naranjo, I, Castellini, P, Castro, D, Castro Meira, F, Cavallini, A, Cayuela Caudevilla, N, Cenciarelli, S, Cereda, C, Cerrone, P, Chakrabarti, A, Chaloulos-Iakovidis, P, Chamorro, A, Chandrasena, D, Chang, DI, Che, C, Chembala, J, Chen, J, Chen, Z, Chen, T, Chen, H, Chen, X, Chen, G, Chen, L, Chen, S, Cheripelli, B, Chin, M, Chiquete Anaya, E, Chorazy, M, Christensen, H, Christensen, T, Christian, L, Chu, F, Chung, CS, Clark, W, Clarke, R, Claverie, S, Clemente Agostoni, E, Clissold, B, Coelho, J, Cohen, D, Colakoglu, S, Collas, D, Condurso, R, Connolly, SJ, Consoli, D, Constantin, C, Constantino Silva, AB, Contardo, L, Corlobe, A, Correia, M, Correia, C, Cortijo Garcia, E, Coull, B, Coutts, S, Coveney, S, Cras, P, Crols, R, Crozier, S, Csanyi, A, Csiba, L, Csontos, K, Csuha, R, Cui, L, Cunha, L, Curtze, S, Czerska, M, Czlonkowska, A, Czurko, M, Czuryszkiewicz, M, Dagnino, M, Dai, C, Daineko, A, Dalek, G, Damgaard, D, Danese, A, Dani, K, Danku, V, Dario Toledo, W, Dávalos, A, De Havenon, A, De Keyser, J, De Klippel, N, De La Torre, J, De Pauw, A, De Smedt, A, De Torres, R, De Vries Basson, MM, Dearborn, J, Deganutto, R, Degeorgia, M, Deguchi, I, Del Giudice, A, Delcourt, C, Delgado-Mederos, R, Della Marca, G, Delpont, B, Deltour, S, Demets, DL, Dennis, M, Desai, J, Devine, J, Dhollander, I, Di Mascio, MT, Diaconu, M, Diaz Otero, F, Dietzel, J, Diez-Tejedor, E, Ding, N, Ding, J, Diomedi, M, Dioszeghy, P, Distefano, M, Domigo, V, Dorodnicov, E, Dossi, D, Doubal, F, Druzenko, I, Du, P, Du, J, Duman, T, Duodu, Y, Dutta, D, Dylewicz, L, Eckstein, J, Ehrensperger, E, Ehrlich, S, Einer Allende, G, Elena Halac, B, Elyas, S, Endres, M, Engelbrecht, JM, Engelter, S, Epinat, M, Eren, F, Esbjornsson, M, Escribano, B, Escudero, I, Esisi, B, Essa, B, Esterbauer, M, Evans, N, Eveson, D, Fabio, S, Fang, L, Fanta, S, Fares, M, Fatar, M, Faust, K, Favate, A, Fazekas, F, Federica Denaro, M, Fedin, A, Felipe Amaya, P, Feng, J, Ferencova, K, Fernanda Gilli, M, Fernandez, MD, Fernandez Pirrone, PN, Fernandez Vera, J, Ferrari, J, Ferreira, A, Ferreira Junior, G, Fidler, M, Field, D, Field, T, Figueroa, C, Fiksa, J, Filipov, A, Firstenfeld, A, Fisch, L, Fischer, U, Fisselier, M, Fiszer, U, Fluri, F, Fortea, G, Fotherby, K, Fraczek, A, France, E, Freitas, G, Frey, S, Frick, M, Friedman, A, Friedrich, M, Frisullo, G, Fryze, W, Fuentes Gimeno, B, Fujigasaki, H, Fukuyama, K, Furlan, A, Furlanis, G, Furnace, J, Gabriel, M, Gabriel Reich, E, Gagliardi, RJ, Galati, F, Galli Giqueauk, E, Gallina, A, Gallinella, E, Gallo, J, Gangadharan, S, Gao, Y, Garcia Lopez, R, Garcia Pastor, A, Garcia Sanchez, SM, Garnauf, M, Garnier, P, Gasecki, D, Gasic, K, Gasiorek, K, Gasser, S, Gaugg, M, Gebreyohanns, M, Gebura, K, Geng, J, Geniz Clavijo, M, Georg Haeusler, K, Geran, R, Geremek, M, Gerocs, Z, Ghia, D, Giannandrea, D, Giatsidis, F, Gien Lopez, JA, Gil Nunez, A, Gimenez, L, Giralt, E, Glabinski, A, Gladstone, D, Gliem, M, Gluszkiewicz, M, Goddeau, R, Gogoleva, E, Gokce, M, Goldemund, D, Golikov, K, Gomes Neto, A, Gomez Schneider, M, Gomez-Choco, M, Gomis, M, Gongora-Rivera, JF, Gonysheva, Y, Gonzalez, L, Gonzalez Toledo, ME, Gottschal, M, Gozdzik, I, Grabowski, S, Graf, S, Green, D, Greer, D, Gregorio, T, Greisenegger, S, Greshnova, I, Griebe, M, Grzesik, M, Guan, J, Guarda, S, Gueguen, A, Guidoux, C, Guillermo Povedano, P, Guillon, B, Guiraudg, V, Gunathilagan, G, Guryanova, N, Gusev, V, Gustavo Persi, G, Gutiérrez, R, Guyler, P, Gyuker, N, Hachinski, V, Hajas, A, Hallevi, H, Hankey, G, Hankey, GJ, Hanouskova, L, Hao, L, Haraguchi, K, Haralur Sreekantaiah, Y, Haratz, S, Hargroves, D, Harkness, K, Harmel, P, Harrasser, M, Hart, RG, Harvey, M, Hasan, R, Hasegawa, Y, Hassan, A, Hattori, M, Hatzitolios, A, Hauk, M, Hayashi, T, Hayhoe, H, Hedna, VS, Heine, M, Held, V, Hellwig, S, Henkner, J, Henninger, N, Hermans, S, Hernandez, J, Herrero, D, Hervieu-Begue, M, Herzig, R, Hicken, L, Hieber, M, Hill, M, Hirose, M, Hobeanu, MC, Hobson, B, Hochstetter, M, Hoe Heo, J, Hoffmann, M, Holmstedt, C, Hon, P, Hong, KS, Honma, Y, Horev, A, Horgan, G, Horvath, L, Horvath, M, Hoyer, C, Huang, D, Huang, H, Huber, B, Huhtakangas, J, Hussain, M, Igarashi, S, Iglesias Mohedano, AM, Ignacio Tembl, J, Impellizzeri, M, Inanc, Y, Ioli, P, Irina Aniculaesei, A, Ishida, K, Itabashi, R, Iversen, H, Jagolino, A, Jakab, K, Jander, S, Janka, H, Jankovych, J, Jansen, J, Jasek, L, Javier Alet, M, Javor, L, Jin, X, Jing, P, Joachim, B, Joan Macleod, M, Johnson, M, Jose Martin, J, Joyner, C, Judit Szabo, K, Jun-Oconnell, A, Jura, R, Kaczorowska, B, Kadlcikova, J, Kahles, T, Kakaletsis, N, Kakuk, I, Kalinowska, K, Kaminska, K, Kaneko, C, Kanellos, I, Kapeller, P, Kapica-Topczewska, K, Karasz, O, Karlinski, M, Karlsson, JE, Kasa, K, Kashaeva, E, Kasner, SE, Kaste, M, Kasza, J, Katalin Iljicsov, A, Katsurayama, M, Kaur, S, Kawanishi, M, Kaygorodtseva, S, Ke, K, Kei, A, Keilitz, J, Kellner, J, Kelly, P, Kelly, S, Kemlink, D, Kerekgyarto, M, Keskinarkaus, I, Khairutdinova, D, Khanna, A, Khaw, A, Kholopov, M, Khoumri, C, Kirpicheva, S, Kirshner, H, Kitagawa, K, Kittner, S, Kivioja, R, Klein, F, Kleindorfer, D, Kleinig, T, Klivenyi, P, Knecht, S, Kobayashi, Y, Kobayashi, A, Koch, M, Koehler, L, Koivu, M, Kolianov, V, Koltsov, I, Kondo, T, Konkov, I, Kopecky, S, Korompoki, E, Korpela, J, Kosarz-Lanczek, K, Koutroubi, A, Kovacs, K, Kovacs, T, Kovacs, H, Kowalczyk, K, Kowalska, M, Krajickova, D, Kral, M, Krarup Hansen, C, Kraska, J, Krebs, S, Krejci, V, Kremer, C, Kreuzpointer, R, Krzyzanowska, M, Kucken, D, Kulakowska, A, Kunzmann, J, Kurenkova, N, Kuris, A, Kurkowska-Jastrzebska, I, Kurtenkova, N, Kurushina, O, Kusnick, G, Kustova, M, Kuwashiro, T, Kwan Cha, J, Lago, A, Lagutenko, M, Lajos, B, Lambeck, J, Lamy, C, Landolfi, A, Lanfranconi, S, Lang, W, Lara Lezama, LB, Lara Rodriguez, B, Largo, T, Lasek-Bal, A, Latte, L, Lauer, V, Lavados, P, Le Bouc, R, Leal Cantu, R, Lechner, H, Lecouturier, K, Leder, S, Lee, J, Lee, BC, Leger, A, Leira, E, Leisse, I, Leker, R, Lembo, G, Lenskaya, L, Leyden, J, Li, G, Li, M, Li, S, Li, J, Liamis, G, Liang, H, Liang, Z, Ligot, N, Lin, H, Lindert, R, Lindgren, A, Linna, M, Litwin, T, Liu, K, Liu, X, Llull, L, Lohninger, B, Longoni, M, Loomis, C, Lopes, D, Lopez Fernandez, M, Lopez Garza, N, Lord, A, Louw, S, Lovasz, R, Lowenkopf, T, Lu, Z, Lubke-Detring, SC, Luder, R, Lujan, S, Luo, B, Lupinogina, L, Luschin, G, Lutsep, H, Lvova, A, Ly, J, Grosse, G.M., Ma, H, Ma, C, Machado, M, Machado, C, Macher, S, Machetanz, J, Macian-Montoro, F, Mackey, E, Mackey, A, Maclean, G, Maestre-Moreno, J, Magadan, A, Magyar, T, Mahagney, A, Majid, A, Majjhoo, A, Makaritsis, K, Mandzia, J, Mangas Guijarro, M, Mangion, D, Manios, E, Mann, S, Manning, L, Manno, C, Manuel Garcia, J, Maqueda, V, Mar Castellanos, M, Mar Freijo, M, Marando, C, Marcela Lepera, S, Marcos Couto, J, Maria Bruera, G, Maria Greco, L, Maria Lorenzo, A, Maria Obmann, S, Maria Roa, A, Marini, C, Marinkovic, I, Mario Sumay, G, Mario Torres, C, Marko, M, Markova, S, Markus, H, Marsh, R, Marsili, E, Marta Esnaola, M, Marta Moreno, J, Marti-Fabregas, J, Martina Angelocola, S, Martínez Sánchez, P, Martinez-Majander, N, Martins, S, Marzelik, O, Mastrocola, S, Matamala, G, Matoltsy, A, Matosevic, B, Matsumoto, S, Maud, A, Mauri Cabdevila, G, May, Z, Mayasi, Y, Mayr, A, Mazzoli, T, Mcarthur, K, Mccullough, L, Medina Pech, CE, Medlin, F, Mehdiratta, M, Mehta, S, Mehta, D, Mehta, B, Melis, M, Melnikova, E, Mendez, B, Mendonca, T, Mengual Chirifie, JJ, Menon, N, Mensch, A, Meseguer, E, Messe, S, Metcalf, K, Meyer, N, Michas, F, Micheletti, N, Mikulik, R, Milionis, H, Miller, B, Milling, T, Minelli, C, Minhas, J, Minns, M, Mircea, D, Mishra, S, Mismas, A, Mistri, A, Mitrovic, N, Miyake, H, Modrau, B, Moey, A, Molina, C, Molina, J, Molis, A, Moller, J, Molnar, S, Moniche, F, Monosi, C, Monzani, V, Moonis, M, Morais, R, Morales, L, Morales, A, Morar-Precup, D, Moreton, F, Moro, C, Morozova, E, Morton, M, Morvan, T, Morvan, E, Motko, T, Mowla, A, Mozhejko, E, Muddegowda, G, Mudhar, O, Mueller, T, Muhl, C, Muir, KW, Mundl, H, Munoz, S, Murphy, C, Murphy, S, Murtuzova, A, Musuka, T, Mutzenbach, J, Myint, M, Mysliwy, W, Naccarato, M, Naeije, G, Nagakane, Y, Natarajan, I, Navaratnam, D, Nave, A, Nazliel, B, Nedeltchev, K, Nel, J, Nell, H, Nemeth, R, Nemeth, L, Neto, O, Ng, K, Ngeh, J, Nicolas Chialvo, L, Nieminen, T, Nikkanen, M, Nikl, J, Nikoforova, M, Nishino, S, Nishiyama, Y, Njovane, X, Nogawa, S, Nombela, F, Norrving, B, Nosek, K, Nowak, B, Nowakowska-Sledz, E, Ntaios, G, Numminen, H, Nunez, F, Obadia, M, Oberndorfer, S, Obrezan, A, Ochiai, J, Oczkowski, W, O'Donnell, MJ, Odyniec, A, Oh, K, Ohira, M, Okamoto, Y, Okpala, M, Okubo, S, Olah, L, Olavarria, V, Oleszek, J, Onat Demirci, N, Ondar, V, Ongun, G, Ooyama, K, Orosz, V, Ortiz, R, Osseby, G, Österlund-Tauriala, E, Ovesen, C, Ozcekic Demirhan, S, Ozdoba-Rot, J, Ozturk, S, Ozyurt, E, Pablo Grecco, M, Pablo Povedano, G, Paciaroni, M, Padiglioni, C, Pagola, J, Palasik, W, Panczel, G, Panos, L, Papadopoulos, G, Papadopoulou, E, Papagiannis, A, Papavasileiou, V, Papina, M, Pardo De Donlebun, JR, Parisi, V, Park, JM, Pasten, J, Patel, N, Pavlik, O, Pawelczyk, M, Peacock, WF, Pei, H, Peisker, T, Pena Sedna, LF, Penn, A, Pentek, S, Pepper, E, Pereira, L, Perera, K, Perez, Y, Perez, S, Perez Leguizamon, P, Pernicka, M, Perry, R, Persico, A, Pesant, Y, Peska, S, Peters, D, Peters, G, Pettigrew, L, Phan, T, Philippi, S, Phinney, T, Pico, F, Pidal, A, Piechowski-Jozwiak, B, Pieroni, A, Pineiro, S, Piras, V, Pizova, N, Polanco, J, Polin, M, Polyakov, A, Polychronopoulou, E, Polymeris, A, Popov, D, Poppe, A, Postorino, P, Pozzerese, C, Pradhan, M, Prats, L, Prazdnichkova, E, Prendl, B, Pretorius, M, Profice, P, Prokopenko, S, Pudov, E, Pujol Lereis, V, Punzo Bravo, G, Purroy, F, Qiu, J, Qu, X, Quenardelle, V, Quesada Garcia, H, Radrizzani, L, Radtke, A, Raffelsberger, T, Ramirez Moreno, JM, Ramos-Estebanez, C, Rani, A, Rapantova, P, Rashed, K, Rasheed Nihara, A, Rasmussen, J, Redondo Robles, L, Reif, M, Reiner, P, Rekova, P, Renu, A, Repetto, M, Reyes, P, Reyes Morales, S, Rha, JH, Ribeiro, J, Ricci, S, Richard, C, Rigual, R, Rinaldi, C, Riveira Rodriguez, C, Rizzato, B, Robinson, TG, Rocco, A, Rodrigues, M, Rodriguez, G, Rodriguez Campello, A, Rodriguez Lucci, F, Rodriguez Yanez, M, Roesler, C, Roffe, C, Roine, R, Roine, S, Roldan, A, Romana Pezzella, F, Romano, M, Roos, JS, Rosso, C, Rostrup Kruuse, C, Roth, Y, Roukens, R, Roveri, L, Rozanski, D, Rozniecki, J, Rozsa, C, Rudilosso, S, Ruiz Ares, G, Ruiz Franco, A, Rum, G, Ruuskanen, J, Rybinnik, I, Ryota, K, Saarinen, J, Saavedra, V, Sabben, C, Sabet, A, Sagris, D, Sahlas, J, Sakai, N, Salamanca, P, Salgado, P, Salig, S, Salletmayr, T, Salnikov, M, Samoshkina, O, Samson, Y, Sanak, D, Sànchez Cerón, M, Santalucia, P, Santamaria Cadavid, M, Santiago, P, Santo, G, Sanz Cuesta, B, Sargento, J, Sarraj, A, Sas, K, Sas, A, Satoshi, O, Satsoglou, S, Sattar, N, Savitz, S, Savopoulos, C, Saw, J, Sawicka, M, Sawyer, R, Scandura, T, Schillinger, N, Schindler, J, Schlachetzki, F, Schneider, I, Schuppner, R, Schurig, J, Schwarzbach, CJ, Sebejova, M, Seidel, G, Sekaran, L, Selcuk, D, Selvarajah, J, Semerano, A, Semjen, J, Semushina, D, Sen, S, Seok Park, M, Serena, J, Serhat Tokgoz, O, Serles, W, Serrano, F, Sevin, M, Seynaeve, L, Shah, S, Shamalov, N, Shang, T, Sharma, M, Sharrief, A, Shazam Hussain, M, Shchukin, I, Shen, W, Shepeleva, E, Shinsuke, I, Shmonin, A, Shoamanesh, A, Shuaib, A, Shulga, A, Sibolt, G, Sibon, I, Sicilia, I, Siebert, M, Sieczkowska, E, Sila, C, Silva, AA, Silva, D, Silva, P, Silva, Y, Silvestrini, M, Simony, Z, Simpkins, A, Singh, B, Sinha, D, Sipos, I, Skoda, O, Skowron, P, Skowronska, M, Sliwinska, B, Slonkova, J, Smolkin, A, Smyth, A, Sobolewski, P, Sobota, A, Sohn, SI, Soldatov, M, Solganov, I, Soloveva, L, Solovyeva, E, Sonntag, N, Soors, P, Sorgun, M, Soriano, C, Spence, D, Spengos, K, Sposato, L, Staaf, G, Stadler, K, Stakhovskaya, L, Stamatelopoulos, K, Steinert, S, Stetkarova, I, Stiehm, M, Stocker, R, Stoinski, J, Stoll, A, Stotts, G, Stumpp, A, Sucapane, P, Suenaga, T, Sun, X, Sundararajan, S, Sung Kim, J, Suzuki, H, Svaneborg, N, Szasz, G, Szczuchniak, W, Szczyrba, S, Szegedi, N, Szekely, A, Szewczyk, Z, Szilagyi, G, Szlufik, S, Szoboszlai, K, Szpisjak, L, Sztajzel, R, Sztriha, L, Ta Wil, SE, Taggeselle, J, Takamatsu, K, Takao, M, Taki, W, Takizawa, S, Talahma, M, Tamayo, A, Tan, J, Tanne, D, Tapanainen, A, Tapiola, T, Tarasiuk, J, Tatlisumak, T, Tayal, A, Tcvetkova, S, Teal, P, Tejada Garcia, J, Tejada Meza, H, Tenora, D, Terceno, M, Terentiou, A, Tezcan, S, Thaler, D, Thomson, A, Thouvenot, E, Tiainen, M, Timberg, I, Timsit, S, Tinchon, A, Tirschwell, D, Togay Isikay, C, Tokunaga, K, Tolino, M, Toloza, C, Tomelleri, G, Tomoyuki, K, Tomppo, LM, Tong, Z, Tong, L, Toni, D, Torres, J, Tossavainen, C, Toth, G, Tountopoulou, A, Touze, E, Tovar, M, Toyoda, K, Trillo, S, Trommer, A, Tropepi, D, Tryambake, D, Tu, H, Tuetuencue, S, Tumova, R, Tumpula, O, Turc, G, Tutaj, A, Tynkkynen, J, Uchiyama, S, Uchwat, U, Uhrinyakova, L, Ulku Acar, R, Uluduz Ugurlu, D, Urra, X, Urui, S, Usero Ruiz, M, Vaclavik, D, Vahedi, K, Valikovics, A, Valpas, J, Van Acker, P, Van Daele, W, Vanderschueren, G, Vanina Jure, L, Varela, R, Varga, Z, Varvat, J, Varvyanskaya, N, Vasco Salgado, A, Vasko, P, Vass, L, Vassilopoulou, S, Vastagh, I, Vazquez, P, Vecsei, L, Veltkamp, R, Venti, M, Verdugo, M, Verocai, V, Veronica Marroquin, M, Veronica Simonsini, C, Veverka, T, Vigl, M, Vila, A, Vilar, C, Villanueva Osorio, JA, Virta, J, Vitkova, E, Voglsperger, B, Volna, J, Von Weitzel-Mudersbach, PA, Vora, N, Voznyuk, I, Wach-Klink, A, Wacongne, A, Walters, D, Wang, Y, Wang, J, Wang, L, Wang, X, Wang, W, Wang, N, Wang, D, Wang, H, Warnack, W, Wartenberg, K, Waters, R, Waters, M, Webb, T, Weber, J, Weiss, G, Weissenborn, K, Weitz, JI, Weller, B, Wen, G, Weng, G, Werner, P, Werring, D, Wester, P, Whiteley, W, Whiting, R, Wijeratne, T, Willems, C, Wilson, L, Wilson, C, Winder, T, Windt, J, Winkler, A, Winska-Tereszkiewicz, A, Wisniewska, A, Wittayer, M, Wlodek, A, Wojnarowska-Arendt, A, Wolf, M, Wolff, V, Wolter, C, Wong, A, Wook Nah, H, Worthmann, H, Wu, W, Wu, S, Wunderlich, S, Wurzinger, H, Wyse, DG, Xiao, B, Xiaopeng, W, Ximenez-Carrillo, A, Xiong, L, Xiong, Y, Xiong, W, Xu, Y, Xu, J, Xu, Z, Yalo, B, Yamada, T, Yamasaki, M, Yang, L, Yang, Y, Yang, X, Yang, Q, Yang, B, Yang, J, Yasuhiro, I, Yee Lam, M, Yegappan, C, Yip, S, Ylikallio, E, Ylikotila, P, Yongwon Jin, A, Yoon, BW, Yoshida, Y, Yperzeele, L, Yuan, H, Yuasa, H, Zalewska, J, Zanferrari, C, Zapata, E, Zboznovits, D, Zelenka, I, Zhang, C, Zhang, B, Zhang, S, Zhang, M, Zhang, X, Zhang, J, Zhao, L, Zhirnova, O, Zhou, L, Zielinska-Turek, J, Zinchenko, I, Ziomek, M, Zitzmann, A, Zweifler, R, Zwiernik, J, Kasner, Scott E, Swaminathan, Balakumar, Lavados, Pablo, Sharma, Mukul, Muir, Keith, Veltkamp, Roland, Ameriso, Sebastian F, Endres, Matthias, Lutsep, Helmi, Messé, Steven R, Spence, J David, Nedeltechev, Krassen, Perera, Kanjana, Santo, Gustavo, Olavarria, Veronica, Lindgren, Arne, Bangdiwala, Shrikant, Shoamanesh, Ashkan, Berkowitz, Scott D, Mundl, Hardi, Connolly, Stuart J, and Hart, Robert G

Published
2018
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6. Possíveis papéis da sestrina2 na esclerose múltipla e suas relações com resultados clínicos

Author

Faruk Omer ODABAS, Ali Ulvi UCA, Turan AKDAG, Filiz DEMİRDÖGEN, Mustafa ALTAS, and Osman Serhat TOKGOZ

Subjects
Inflammation, Multiple Sclerosis, Apoptose, Sestrins, Estresse Oxidativo, Nuclear Proteins, Apoptosis, Oxidative Stress, Inflamação, Multiple Sclerosis, Relapsing-Remitting, Biomarcadores, Neurology, ROC Curve, Esclerose Múltipla, Humans, Neurology (clinical), Sestrinas, Biomarkers
Abstract

Background: Characterized by demyelination, inflammation and axonal damage, multiple sclerosis (MS) is one of the most common disorders of central nervous system led by the immune system. There is an urgent and obvious need for biomarkers for the diagnosis and follow-up of MS. Objective: To investigate serum levels of sestrin2 (SESN2), a protein that responds to acute stress, in MS patients. Methods: A total of 85 participants, 40 patients diagnosed previously with relapsing-remitting MS and 45 healthy controls, were included. Serum SESN2 parameters were investigated in blood samples drawn from each participant in the patient and control groups. Results: SESN2 levels were significantly lower in MS patients than in controls (z: -3.06; p=0.002). In the ROC analysis of SESN2, the predictive level for MS was 2.36 ng/mL [sensitivity, 72.50%; specificity, 55.56%; p=0.002; area under the curve (AUC)=0.693]. For the cut-off value in both groups, SESN2 was an independent predictor for MS [Exp (B)=3.977, 95% confidence interval (95%CI) 1.507-10.494 and p=0.013]. Conclusions: The decreased expression of SESN2 may play a role in MS pathogenesis, and SESN2 could be used as a biomarker for MS and as immunotherapeutic agent to treat MS. RESUMO Antecedentes: Caracterizada por desmielinização, inflamação e dano axonal, a esclerose múltipla (EM) é uma das doenças mais comuns do sistema nervoso central liderada pelo sistema imunológico. Há uma necessidade urgente e óbvia de biomarcadores para o diagnóstico e acompanhamento da EM. Objetivo: Investigar os níveis séricos de sestrina2 (SESN2), uma proteína que responde ao estresse agudo, em pacientes com EM. Métodos: Foram incluídos 85 participantes, 40 pacientes com diagnóstico prévio de EM recorrente-remitente e 45 controles saudáveis. Os parâmetros do SESN2 sérico foram investigados em amostras de sangue coletadas de cada participante nos grupos de paciente e controle. Resultados: os níveis de SESN2 foram significativamente mais baixos em pacientes com EM do que em controles (z: -3,06; p=0,002). Na análise ROC do SESN2, o nível preditivo para MS foi 2,36 ng/mL [sensibilidade, 72,50%; especificidade, 55,56%; p=0,002; área sob a curva (AUC)=0,693]. Para o valor de corte em ambos os grupos, SESN2 foi um preditor independente para MS [Exp (B)=3,977, intervalo de confiança de 95% (95%CI) 1,507-10,494; p=0,013]. Conclusões: A expressão diminuída de SESN2 pode desempenhar um papel na patogênese da EM, e SESN2 poderia ser usado como um biomarcador para EM e como agente imunoterapêutico para o tratamento de EM.

Published
2022

7. Effect of Extractum cepae, heparin sodium and allantoin combination (Contractubex

Author

Sener, Balas, Serhat, Tokgoz, Kerim Bora, Yilmaz, Evrim, Onder, Harun, Karabacak, Melih, Akinci, Bahattin, Bayar, and Attila, Isgoren

Abstract

Reoperative thyroid surgery is technically difficult process with increased complications due to the adhesions and fibrosis caused by the previous surgery. In this experimental animal model, we planned to investigate the effect of ContracttubexThe current study is an experimental animal model of post-thyroidectomy adhesion. Twelve Wistar-Albino male rats in two groups were used. Under sterile conditions, a midline incision on the neck was made. The anterior thyroid muscles were separated and the thyroid lodge was reached. As a minor interventional procedure, a sponge was applied to the thyroid tissue, and then a combination of 1 g Extractum capae, heparin, sodium, and allantoin was applied to the dissection site in the drug group. Rats in both groups were sacrificed on 30In the experimental group in which ContractubexContractubex

Published
2021

8. Acute-Phase Stroke Outcome and Lipids

Author

Osman, Serhat Tokgoz, Figen, Guney, Ahmet, Kaya, Ahmet, Bugrul, Esra, Eruyar, Huseyin, Buyukgol, Abdullah, Seyithanoglu, and Mehmet, Sinan Iyisoy

Subjects
medicine.medical_specialty, business.industry, Internal medicine, Phase (matter), Stroke outcome, Cardiology, medicine, General Medicine, business
Abstract

The aim of the study is to investigate the relationship of lipid subgroups with short-term mortality in acute stroke (AS).This retrospective study included 698 patients with AS who presented within 24 h of symptom onset. A hemogram from peripheral venous blood samples was taken at admission. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), TC/HDL-C rate, and TG/HDL-C rate were recorded. Duration of follow-up was defined as 30 days.64 out of 698 patients died during the follow-up period. The mean TG, TG/HDL-C, and TC/HDL-C levels were significantly lower in the mortality group than the survival group. In the receiver operating characteristic (ROC) analysis, the cutoff values and area under the curve of the TG, TG/HDL-C, TC, and TC/HDL-C levels for short-term stroke mortality are as follows ([100.2 mg/dL, 0.648]; [2.52, 0.650]; [170.50 mg/dL, 0.598]; and [4.32, 0.640], respectively). In the Cox regression model, only TG and TG/HDL-C, according to their ROC cutoff values, were independent variables as short-term mortality predictors (TG ≤100.2 mg/dL, HR:2.413 , 95% CI: 1.345-4.327, P:0.004); (TG/HDL ≤2.56, HR: 2.720, 95% CI: 1.389-5.359, P:0.003, respectively).Dyslipidemia is a well-known as a risk factor of stroke. However, this study focused on the estimation that lower TG and TG/HDL-C levels at the time of hospital admission might be predictors of short-term mortality within a month of AS attack, which is a different subject from long term risk factors of stroke. Serum TG level may be a better indicator for mortality in the acute hypercatabolic trauma such as stroke.

Published
2021

9. Musical mirror-symmetrical movement tasks: comparison of rhythm versus melody-playing

Author

Tolga Çukur, Nurtug Bariseri, Yusuf Şahin, Barkin Ilhan, Serhat Tokgoz, Demet Aydogdu, Batu Ozturkler, and Çukur, Tolga

Subjects
0301 basic medicine, Male, Cerebellum, Movement, Motor Activity, Lateralization of brain function, Functional Laterality, Left thalamus, Fingers, 03 medical and health sciences, 0302 clinical medicine, Rhythm, Motor control, In-phase movement, Mirror-symmetrical movement, medicine, Humans, Brain Mapping, General Neuroscience, Left putamen, Brain, Magnetic Resonance Imaging, 030104 developmental biology, medicine.anatomical_structure, Right cerebral cortex, Laterality, Female, Psychology, Neuroscience, 030217 neurology & neurosurgery, Music
Abstract

Bimanual mirror-symmetrical movement (MSM) is relatively easy to control movement. Different MSM tasks may have different activations and interhemispheric interactions. The purpose of this study is to compare anatomo-physiological features such as hemispheric activations and dominance of two different MSMs, namely melody-playing and rhythm. We examined functional MRI (fMRI) recordings in a group of fifteen right-handed pianists performing two separate tasks: bimanual rhythm and bimanual melody-playing on two different keyboards with standard key order for right hand and reversed for left hand, which allows homolog fingers' movements. Activations and laterality indices on fMRI were examined. The results show that significant cerebellar activations (especially in anterior cerebellum) in both groups. Significant primary sensorimotor cortical activations are observed in the melody-playing group. While there are also bilaterally symmetric activations, and laterality indices suggest overall lateralization towards the left hemisphere in both groups. Activations in the left fronto-parietal cortex, left putamen and left thalamus in conjunction with right cerebellar activations suggest that the left cortico-thalamo-cerebellar loop may be a dominant loop. Dynamic causal modeling (DCM) indicates the presence of causal influences from the left to the right cerebral cortex. In conclusion, melody-playing with bimanual MSM is a complex in-phase task and may help activate the bilateral cortical areas, and left hemisphere is dominant according to laterality indices and DCM results. On the other hand, bimanual rhythm is a simpler in-phase task and may help activate subcortical areas, which might be independent of the voluntary cortical task.

Published
2020

10. Psychiatric Symptoms, Aggression, and Sexual Dysfunction Among Patients With Benign Anal Conditions

Author

Muzaffer Akkoca, Akin Firat Kocaay, Serhat Tokgoz, Saadettin Er, Berker Duman, Tugba Ayaz, Hakan Kumbasar, Derya Gokmen, Mehmet Ali Koç, and Mehmet Ayhan Kuzu

Subjects
Inflammation, benign anorectal diseases, aggression, Psychological Stress, General Medicine, hemorrhoid, psychiatric symptoms, C-Reactive Protein, Impact, Hostility, anal fistula, Disease, Irritable-Bowel-Syndrome, Ratio
Abstract

Introduction The aim of this study was to investigate the incidence of general psychiatric symptoms, aggression levels, and sexual dysfunction in patients with benign anorectal diseases and compare the results with those of healthy control subjects. Methods We prospectively enrolled consecutive adult patients who presented for treatment of benign perianal diseases and healthy control subjects between June 2017 and December 2018. All patients had either grade 3 or 4 hemorrhoidal disease or perianal fistula with active discharge who had not undergone previous anorectal surgery. We also included a control group with benign subcutaneous lumps presenting for minor surgery. We used the Symptom Checklist-90-Revised Form to evaluate general psychiatric symptoms, the Buss-Perry Aggression Questionnaire (BPAQ) to evaluate aggression levels, and the Arizona Sexual Experiences Scale to evaluate sexual dysfunction. Results A total of 563 patients were assessed for eligibility; after exclusions, 94 with anal fistula, 89 with hemorrhoids, and 59 healthy control subjects were enrolled. The groups were similar with regard to age, gender, and educational level. Physical and verbal aggression, anger, and total BPAQ score were significantly higher in patients with perianal fistula than in those with hemorrhoidal disease and healthy control subjects ( P < .001). Conclusion This study suggests that patients with perianal fistula have higher levels of aggression than healthy control subjects and those with hemorrhoidal disease. One must bear this in mind during preoperative patient evaluations and obtaining informed consent. Further studies are needed to investigate the reason for this association and potential causality.

Published
2022

12. Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

Author

Scott E Kasner, Balakumar Swaminathan, Pablo Lavados, Mukul Sharma, Keith Muir, Roland Veltkamp, Sebastian F Ameriso, Matthias Endres, Helmi Lutsep, Steven R Messé, J David Spence, Krassen Nedeltechev, Kanjana Perera, Gustavo Santo, Veronica Olavarria, Arne Lindgren, Shrikant Bangdiwala, Ashkan Shoamanesh, Scott D Berkowitz, Hardi Mundl, Stuart J Connolly, Robert G Hart, N Abdelhamid, D Abdul Rahman, M Abdul-Saheb, P Abreu, M Abroskina, F Abu Ahmad, S Accassat, M Acciaresi, A Adami, N Ahmad, F Ahmed, M Alberto Hawkes, F Alemseged, A Ali, R Altavilla, L Alwis, P Amarenco, S Amaro, LE Amaya Sanchez, A Amelia Pinto, SF Ameriso, H Amin, T Amino, AK Amjad, E Anagnostou, G Andersen, C Anderson, DC Anderson, M Andrea Falco, F Andres Mackinnon, D Andreu, M Androulakis, M Angel Gamero, G Angel Saredo, R Angeles Diaz, M Angels Font, S Anticoli, A Arauz, AA Arauz Gongora, P Araya, JF Arenillas Lara, S Arias Rivas, M Arnold, S Augustin, W Avelar, E Azevedo, V Babikian, A Bacellar, K Badalyan, HJ Bae, EM Baez Martinez, H Bagelmann, P Bailey, Z Bak, M Baker, A Balazs, D Baldaranov, I Balogun, T Balueva, Z Bankuti, M Bar, A Baranowska, J Bardutzky, S Barker Trejo, J Barlinn, F Baronnet, C Barroso, M Barteys, T Bartolottiova, A Barulin, M Bas, S Bashir, V Basile, R Bathe-Peters, R Bathula, C Batista, H Batur Caglayan, P Baumgartner, R Bazan, O Bazhenova, M Beaudry, J Beer, Y Behnam, C Beilei, A Beinlich, Y Bejot, A Belkin, OR Benavente, A Benjamin, V Berardi, D Bereczki, SD Berkowitz, J Berlingieri, W Berrios, J Berrouschot, M Bhandari, M Bhargavah, H Bicker, T Bicsak, M Bilik, D Bindila, J Birchenall, L Birnbaum, T Black, D Blacker, D Blacquiere, C Blanc-Labarre, C Blank, B Blazejewska-Hyzorek, S Bloch, E Bodiguel, E Bogdanov, L Boos, L Borcsik, N Bornstein, S Bouly, G Braga, I Bragado, MC Bravi, C Brokalaki, W Brola, R Brouns, D Bruce, J Brzoska-Mizgalska, B Buck, M Buksinska-Lisik, J Burke, M Burn, G Bustamante, L Cabrejo, K Cai, S Cajaraville, M Calejo, D Calvet, J Campillo, E Campos Costa, P Camps, H Can Alaydin, E Candeloro, C Canepa, CG Cantu Brito, M Cappellari, C Carcel, P Cardona Portela, F Cardoso, M Carek, M Carletti, J Carlos Portilla, P Caruso, I Casado-Naranjo, P Castellini, D Castro, F Castro Meira, A Cavallini, N Cayuela Caudevilla, S Cenciarelli, C Cereda, P Cerrone, A Chakrabarti, P Chaloulos-Iakovidis, A Chamorro, D Chandrasena, DI Chang, C Che, J Chembala, J Chen, Z Chen, T Chen, H Chen, X Chen, G Chen, L Chen, S Chen, B Cheripelli, M Chin, E Chiquete Anaya, M Chorazy, H Christensen, T Christensen, L Christian, F Chu, CS Chung, W Clark, R Clarke, S Claverie, E Clemente Agostoni, B Clissold, J Coelho, D Cohen, S Colakoglu, D Collas, R Condurso, SJ Connolly, D Consoli, C Constantin, AB Constantino Silva, L Contardo, A Corlobe, M Correia, C Correia, E Cortijo Garcia, B Coull, S Coutts, S Coveney, P Cras, R Crols, S Crozier, A Csanyi, L Csiba, K Csontos, R Csuha, L Cui, L Cunha, S Curtze, M Czerska, A Czlonkowska, M Czurko, M Czuryszkiewicz, M Dagnino, C Dai, A Daineko, G Dalek, D Damgaard, A Danese, K Dani, V Danku, W Dario Toledo, A Dávalos, A De Havenon, J De Keyser, N De Klippel, J De La Torre, A De Pauw, A De Smedt, R De Torres, MM De Vries Basson, J Dearborn, R Deganutto, M Degeorgia, I Deguchi, A Del Giudice, C Delcourt, R Delgado-Mederos, G Della Marca, B Delpont, S Deltour, DL Demets, M Dennis, J Desai, J Devine, I Dhollander, MT Di Mascio, M Diaconu, F Diaz Otero, J Dietzel, E Diez-Tejedor, N Ding, J Ding, M Diomedi, P Dioszeghy, M Distefano, V Domigo, E Dorodnicov, D Dossi, F Doubal, I Druzenko, P Du, J Du, T Duman, Y Duodu, D Dutta, L Dylewicz, J Eckstein, E Ehrensperger, S Ehrlich, G Einer Allende, B Elena Halac, S Elyas, M Endres, JM Engelbrecht, S Engelter, M Epinat, F Eren, M Esbjornsson, B Escribano, I Escudero, B Esisi, B Essa, M Esterbauer, N Evans, D Eveson, S Fabio, L Fang, S Fanta, M Fares, M Fatar, K Faust, A Favate, F Fazekas, M Federica Denaro, A Fedin, P Felipe Amaya, J Feng, K Ferencova, M Fernanda Gilli, MD Fernandez, PN Fernandez Pirrone, J Fernandez Vera, J Ferrari, A Ferreira, G Ferreira Junior, M Fidler, D Field, T Field, C Figueroa, J Fiksa, A Filipov, A Firstenfeld, L Fisch, U Fischer, M Fisselier, U Fiszer, F Fluri, G Fortea, K Fotherby, A Fraczek, E France, G Freitas, S Frey, M Frick, A Friedman, M Friedrich, G Frisullo, W Fryze, B Fuentes Gimeno, H Fujigasaki, K Fukuyama, A Furlan, G Furlanis, J Furnace, M Gabriel, E Gabriel Reich, RJ Gagliardi, F Galati, E Galli Giqueauk, A Gallina, E Gallinella, J Gallo, S Gangadharan, Y Gao, R Garcia Lopez, A Garcia Pastor, SM Garcia Sanchez, M Garnauf, P Garnier, D Gasecki, K Gasic, K Gasiorek, S Gasser, M Gaugg, M Gebreyohanns, K Gebura, J Geng, M Geniz Clavijo, K Georg Haeusler, R Geran, M Geremek, Z Gerocs, D Ghia, D Giannandrea, F Giatsidis, JA Gien Lopez, A Gil Nunez, L Gimenez, E Giralt, A Glabinski, D Gladstone, M Gliem, M Gluszkiewicz, R Goddeau, E Gogoleva, M Gokce, D Goldemund, K Golikov, A Gomes Neto, M Gomez Schneider, M Gomez-Choco, M Gomis, JF Gongora-Rivera, Y Gonysheva, L Gonzalez, ME Gonzalez Toledo, M Gottschal, I Gozdzik, S Grabowski, S Graf, D Green, D Greer, T Gregorio, S Greisenegger, I Greshnova, M Griebe, M Grzesik, J Guan, S Guarda, A Gueguen, C Guidoux, P Guillermo Povedano, B Guillon, V Guiraudg, G Gunathilagan, N Guryanova, V Gusev, G Gustavo Persi, R Gutiérrez, P Guyler, N Gyuker, V Hachinski, A Hajas, H Hallevi, G Hankey, GJ Hankey, L Hanouskova, L Hao, K Haraguchi, Y Haralur Sreekantaiah, S Haratz, D Hargroves, K Harkness, P Harmel, M Harrasser, RG Hart, M Harvey, R Hasan, Y Hasegawa, A Hassan, M Hattori, A Hatzitolios, M Hauk, T Hayashi, H Hayhoe, VS Hedna, M Heine, V Held, S Hellwig, J Henkner, N Henninger, S Hermans, J Hernandez, D Herrero, M Hervieu-Begue, R Herzig, L Hicken, M Hieber, M Hill, M Hirose, MC Hobeanu, B Hobson, M Hochstetter, J Hoe Heo, M Hoffmann, C Holmstedt, P Hon, KS Hong, Y Honma, A Horev, G Horgan, L Horvath, M Horvath, C Hoyer, D Huang, H Huang, B Huber, J Huhtakangas, M Hussain, S Igarashi, AM Iglesias Mohedano, J Ignacio Tembl, M Impellizzeri, Y Inanc, P Ioli, A Irina Aniculaesei, K Ishida, R Itabashi, H Iversen, A Jagolino, K Jakab, S Jander, H Janka, J Jankovych, J Jansen, L Jasek, M Javier Alet, L Javor, X Jin, P Jing, B Joachim, M Joan Macleod, M Johnson, J Jose Martin, C Joyner, K Judit Szabo, A Jun-Oconnell, R Jura, B Kaczorowska, J Kadlcikova, T Kahles, N Kakaletsis, I Kakuk, K Kalinowska, K Kaminska, C Kaneko, I Kanellos, P Kapeller, K Kapica-Topczewska, O Karasz, M Karlinski, JE Karlsson, K Kasa, E Kashaeva, SE Kasner, M Kaste, J Kasza, A Katalin Iljicsov, M Katsurayama, S Kaur, M Kawanishi, S Kaygorodtseva, K Ke, A Kei, J Keilitz, J Kellner, P Kelly, S Kelly, D Kemlink, M Kerekgyarto, I Keskinarkaus, D Khairutdinova, A Khanna, A Khaw, M Kholopov, C Khoumri, S Kirpicheva, H Kirshner, K Kitagawa, S Kittner, R Kivioja, F Klein, D Kleindorfer, T Kleinig, P Klivenyi, S Knecht, Y Kobayashi, A Kobayashi, M Koch, L Koehler, M Koivu, 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Solovyeva, N Sonntag, P Soors, M Sorgun, C Soriano, D Spence, K Spengos, L Sposato, G Staaf, K Stadler, L Stakhovskaya, K Stamatelopoulos, S Steinert, I Stetkarova, M Stiehm, R Stocker, J Stoinski, A Stoll, G Stotts, A Stumpp, P Sucapane, T Suenaga, X Sun, S Sundararajan, J Sung Kim, H Suzuki, N Svaneborg, G Szasz, W Szczuchniak, S Szczyrba, N Szegedi, A Szekely, Z Szewczyk, G Szilagyi, S Szlufik, K Szoboszlai, L Szpisjak, R Sztajzel, L Sztriha, SE Ta Wil, J Taggeselle, K Takamatsu, M Takao, W Taki, S Takizawa, M Talahma, A Tamayo, J Tan, D Tanne, A Tapanainen, T Tapiola, J Tarasiuk, T Tatlisumak, A Tayal, S Tcvetkova, P Teal, J Tejada Garcia, H Tejada Meza, D Tenora, M Terceno, A Terentiou, S Tezcan, D Thaler, A Thomson, E Thouvenot, M Tiainen, I Timberg, S Timsit, A Tinchon, D Tirschwell, C Togay Isikay, K Tokunaga, M Tolino, C Toloza, G Tomelleri, K Tomoyuki, LM Tomppo, Z Tong, L Tong, D Toni, J Torres, C Tossavainen, G Toth, A Tountopoulou, E Touze, M Tovar, K Toyoda, S Trillo, A Trommer, D Tropepi, D Tryambake, H Tu, S Tuetuencue, R Tumova, O Tumpula, G Turc, A Tutaj, J Tynkkynen, S Uchiyama, U Uchwat, L Uhrinyakova, R Ulku Acar, D Uluduz Ugurlu, X Urra, S Urui, M Usero Ruiz, D Vaclavik, K Vahedi, A Valikovics, J Valpas, P Van Acker, W Van Daele, G Vanderschueren, L Vanina Jure, R Varela, Z Varga, J Varvat, N Varvyanskaya, A Vasco Salgado, P Vasko, L Vass, S Vassilopoulou, I Vastagh, P Vazquez, L Vecsei, R Veltkamp, M Venti, M Verdugo, V Verocai, M Veronica Marroquin, C Veronica Simonsini, T Veverka, M Vigl, A Vila, C Vilar, JA Villanueva Osorio, J Virta, E Vitkova, B Voglsperger, J Volna, PA Von Weitzel-Mudersbach, N Vora, I Voznyuk, A Wach-Klink, A Wacongne, D Walters, Y Wang, J Wang, L Wang, X Wang, W Wang, N Wang, D Wang, H Wang, W Warnack, K Wartenberg, R Waters, M Waters, T Webb, J Weber, G Weiss, K Weissenborn, JI Weitz, B Weller, G Wen, G Weng, P Werner, D Werring, P Wester, W Whiteley, R Whiting, T Wijeratne, C Willems, L Wilson, C Wilson, T Winder, J Windt, A Winkler, A Winska-Tereszkiewicz, A Wisniewska, M Wittayer, A Wlodek, A Wojnarowska-Arendt, M Wolf, V Wolff, C Wolter, A Wong, H Wook Nah, H Worthmann, W Wu, S Wu, S Wunderlich, H Wurzinger, DG Wyse, B Xiao, W Xiaopeng, A Ximenez-Carrillo, L Xiong, Y Xiong, W Xiong, Y Xu, J Xu, Z Xu, B Yalo, T Yamada, M Yamasaki, L Yang, Y Yang, X Yang, Q Yang, B Yang, J Yang, I Yasuhiro, M Yee Lam, C Yegappan, S Yip, E Ylikallio, P Ylikotila, A Yongwon Jin, BW Yoon, Y Yoshida, L Yperzeele, H Yuan, H Yuasa, J Zalewska, C Zanferrari, E Zapata, D Zboznovits, I Zelenka, C Zhang, B Zhang, S Zhang, M Zhang, X Zhang, J Zhang, L Zhao, O Zhirnova, L Zhou, J Zielinska-Turek, I Zinchenko, M Ziomek, A Zitzmann, R Zweifler, J Zwiernik, Yperzeele, Laetitia, and NAVIGATE ESUS Investigators

Subjects
Male, International Cooperation, 030204 cardiovascular system & hematology, antiplatelet therapy, law.invention, Neurology (clinical), ischemic stroke, anticoagulation, Cohort Studies, 0302 clinical medicine, Randomized controlled trial, Rivaroxaban, law, Stroke, education.field_of_study, Aspirin, Anticoagulant, Settore BIO/14, Middle Aged, 3. Good health, Treatment Outcome, N/A, Cardiology, Platelet aggregation inhibitor, Settore MED/26 - Neurologia, Female, medicine.drug, medicine.medical_specialty, medicine.drug_class, MEDLINE, Population, Foramen Ovale, Patent, Subgroup analysis, Article, Statistics, Nonparametric, 03 medical and health sciences, Double-Blind Method, Internal medicine, medicine, Humans, education, Aged, business.industry, medicine.disease, Human medicine, business, 030217 neurology & neurosurgery, Platelet Aggregation Inhibitors, Factor Xa Inhibitors
Abstract

Background: \ud Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial.\ud \ud Methods: \ud NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries that assessed the efficacy and safety of rivaroxaban versus aspirin for secondary stroke prevention in patients with ESUS. For this prespecified subgroup analysis, cohorts with and without PFO were defined on the basis of transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE). The primary efficacy outcome was time to recurrent ischaemic stroke between treatment groups. The primary safety outcome was major bleeding, according to the criteria of the International Society of Thrombosis and Haemostasis. The primary analyses were based on the intention-to-treat population. Additionally, we did a systematic review and random-effects meta-analysis of studies in which patients with cryptogenic stroke and PFO were randomly assigned to receive anticoagulant or antiplatelet therapy.\ud \ud Findings: \ud Between Dec 23, 2014, and Sept 20, 2017, 7213 participants were enrolled and assigned to receive rivaroxaban (n=3609) or aspirin (n=3604). Patients were followed up for a mean of 11 months because of early trial termination. PFO was reported as present in 534 (7·4%) patients on the basis of either TTE or TOE. Patients with PFO assigned to receive aspirin had a recurrent ischaemic stroke rate of 4·8 events per 100 person-years compared with 2·6 events per 100 person-years in those treated with rivaroxaban. Among patients with known PFO, there was insufficient evidence to support a difference in risk of recurrent ischaemic stroke between rivaroxaban and aspirin (hazard ratio [HR] 0·54; 95% CI 0·22–1·36), and the risk was similar for those without known PFO (1·06; 0·84–1·33; pinteraction=0·18). The risks of major bleeding with rivaroxaban versus aspirin were similar in patients with PFO detected (HR 2·05; 95% CI 0·51–8·18) and in those without PFO detected (HR 2·82; 95% CI 1·69–4·70; pinteraction=0·68). The random-effects meta-analysis combined data from NAVIGATE ESUS with data from two previous trials (PICSS and CLOSE) and yielded a summary odds ratio of 0·48 (95% CI 0·24–0·96; p=0·04) for ischaemic stroke in favour of anticoagulation, without evidence of heterogeneity.\ud \ud Interpretation: \ud Among patients with ESUS who have PFO, anticoagulation might reduce the risk of recurrent stroke by about half, although substantial imprecision remains. Dedicated trials of anticoagulation versus antiplatelet therapy or PFO closure, or both, are warranted.\ud \ud Funding: \ud Bayer and Janssen.

Published
2018

13. Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

Author

Kasner, Scott E, primary, Swaminathan, Balakumar, additional, Lavados, Pablo, additional, Sharma, Mukul, additional, Muir, Keith, additional, Veltkamp, Roland, additional, Ameriso, Sebastian F, additional, Endres, Matthias, additional, Lutsep, Helmi, additional, Messé, Steven R, additional, Spence, J David, additional, Nedeltechev, Krassen, additional, Perera, Kanjana, additional, Santo, Gustavo, additional, Olavarria, Veronica, additional, Lindgren, Arne, additional, Bangdiwala, Shrikant, additional, Shoamanesh, Ashkan, additional, Berkowitz, Scott D, additional, Mundl, Hardi, additional, Connolly, Stuart J, additional, Hart, Robert G, additional, Abdelhamid, N, additional, Abdul Rahman, D, additional, Abdul-Saheb, M, additional, Abreu, P, additional, Abroskina, M, additional, Abu Ahmad, F, additional, Accassat, S, additional, Acciaresi, M, additional, Adami, A, additional, Ahmad, N, additional, Ahmed, F, additional, Alberto Hawkes, M, additional, Alemseged, F, additional, Ali, A, additional, Altavilla, R, additional, Alwis, L, additional, Amarenco, P, additional, Amaro, S, additional, Amaya Sanchez, LE, additional, Amelia Pinto, A, additional, Ameriso, SF, additional, Amin, H, additional, Amino, T, additional, Amjad, AK, additional, Anagnostou, E, additional, Andersen, G, additional, Anderson, C, additional, Anderson, DC, additional, Andrea Falco, M, additional, Andres Mackinnon, F, additional, Andreu, D, additional, Androulakis, M, additional, Angel Gamero, M, additional, Angel Saredo, G, additional, Angeles Diaz, R, additional, Angels Font, M, additional, Anticoli, S, additional, Arauz, A, additional, Arauz Gongora, AA, additional, Araya, P, additional, Arenillas Lara, JF, additional, Arias Rivas, S, additional, Arnold, M, additional, Augustin, S, additional, Avelar, W, additional, Azevedo, E, additional, Babikian, V, additional, Bacellar, A, additional, Badalyan, K, additional, Bae, HJ, additional, Baez Martinez, EM, additional, Bagelmann, H, additional, Bailey, P, additional, Bak, Z, additional, Baker, M, additional, Balazs, A, additional, Baldaranov, D, additional, Balogun, I, additional, Balueva, T, additional, Bankuti, Z, additional, Bar, M, additional, Baranowska, A, additional, Bardutzky, J, additional, Barker Trejo, S, additional, Barlinn, J, additional, Baronnet, F, additional, Barroso, C, additional, Barteys, M, additional, Bartolottiova, T, additional, Barulin, A, additional, Bas, M, additional, Bashir, S, additional, Basile, V, additional, Bathe-Peters, R, additional, Bathula, R, additional, Batista, C, additional, Batur Caglayan, H, additional, Baumgartner, P, additional, Bazan, R, additional, Bazhenova, O, additional, Beaudry, M, additional, Beer, J, additional, Behnam, Y, additional, Beilei, C, additional, Beinlich, A, additional, Bejot, Y, additional, Belkin, A, additional, Benavente, OR, additional, Benjamin, A, additional, Berardi, V, additional, Bereczki, D, additional, Berkowitz, SD, additional, Berlingieri, J, additional, Berrios, W, additional, Berrouschot, J, additional, Bhandari, M, additional, Bhargavah, M, additional, Bicker, H, additional, Bicsak, T, additional, Bilik, M, additional, Bindila, D, additional, Birchenall, J, additional, Birnbaum, L, additional, Black, T, additional, Blacker, D, additional, Blacquiere, D, additional, Blanc-Labarre, C, additional, Blank, C, additional, Blazejewska-Hyzorek, B, additional, Bloch, S, additional, Bodiguel, E, additional, Bogdanov, E, additional, Boos, L, additional, Borcsik, L, additional, Bornstein, N, additional, Bouly, S, additional, Braga, G, additional, Bragado, I, additional, Bravi, MC, additional, Brokalaki, C, additional, Brola, W, additional, Brouns, R, additional, Bruce, D, additional, Brzoska-Mizgalska, J, additional, Buck, B, additional, Buksinska-Lisik, M, additional, Burke, J, additional, Burn, M, additional, Bustamante, G, additional, Cabrejo, L, additional, Cai, K, additional, Cajaraville, S, additional, Calejo, M, additional, 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2018
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14. Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

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Kasner, S. E., Swaminathan, B., Lavados, P., Sharma, M., Muir, K., Veltkamp, R., Ameriso, S. F., Endres, M., Lutsep, H., Messe, S. R., Spence, J. D., Nedeltechev, K., Perera, K., Santo, G., Olavarria, V., Lindgren, A., Bangdiwala, S., Shoamanesh, A., Berkowitz, S. D., Mundl, H., Connolly, S. J., Hart, R. G., Abdelhamid, N., Abdul Rahman, D., Abdul-Saheb, M., Abreu, P., Abroskina, M., Abu Ahmad, F., Accassat, S., Acciaresi, M., Adami, A., Ahmad, N., Ahmed, F., Alberto Hawkes, M., Alemseged, F., Ali, A., Altavilla, R., Alwis, L., Amarenco, P., Amaro, S., Amaya Sanchez, L. E., Amelia Pinto, A., Amin, H., Amino, T., Amjad, A. K., Anagnostou, E., Andersen, G., Anderson, C., Anderson, D. C., Andrea Falco, M., Andres Mackinnon, F., Andreu, D., Androulakis, M., Angel Gamero, M., Angel Saredo, G., Angeles Diaz, R., Angels Font, M., Anticoli, S., Arauz, A., Arauz Gongora, A. A., Araya, P., Arenillas Lara, J. F., Arias Rivas, S., Arnold, M., Augustin, S., Avelar, W., Azevedo, E., Babikian, V., Bacellar, A., Badalyan, K., Bae, H. J., Baez Martinez, E. M., Bagelmann, H., Bailey, P., Bak, Z., Baker, M., Balazs, A., Baldaranov, D., Balogun, I., Balueva, T., Bankuti, Z., Bar, M., Baranowska, A., Bardutzky, J., Barker Trejo, S., Barlinn, J., Baronnet, F., Barroso, C., Barteys, M., Bartolottiova, T., Barulin, A., Bas, M., Bashir, S., Basile, V., Bathe-Peters, R., Bathula, R., Batista, C., Batur Caglayan, H., Baumgartner, P., Bazan, R., Bazhenova, O., Beaudry, M., Beer, J., Behnam, Y., Beilei, C., Beinlich, A., Bejot, Y., Belkin, A., Benavente, O. R., Benjamin, A., Berardi, V., Bereczki, D., Berlingieri, J., Berrios, W., Berrouschot, J., Bhandari, M., Bhargavah, M., Bicker, H., Bicsak, T., Bilik, M., Bindila, D., Birchenall, J., Birnbaum, L., Black, T., Blacker, D., Blacquiere, D., Blanc-Labarre, C., Blank, C., Blazejewska-Hyzorek, B., Bloch, S., Bodiguel, E., Bogdanov, E., Boos, L., Borcsik, L., Bornstein, N., Bouly, S., Braga, G., Bragado, I., Bravi, M. C., Brokalaki, C., Brola, W., Brouns, R., Bruce, D., Brzoska-Mizgalska, J., Buck, B., Buksinska-Lisik, M., Burke, J., Burn, M., Bustamante, G., Cabrejo, L., Cai, K., Cajaraville, S., Calejo, M., Calvet, D., Campillo, J., Campos Costa, E., Camps, P., Can Alaydin, H., Candeloro, E., Canepa, C., Cantu Brito, C. G., Cappellari, M., Carcel, C., Cardona Portela, P., Cardoso, F., Carek, M., Carletti, M., Carlos Portilla, J., Caruso, P., Casado-Naranjo, I., Castellini, P., Castro, D., Castro Meira, F., Cavallini, A., Cayuela Caudevilla, N., Cenciarelli, S., Cereda, C., Cerrone, P., Chakrabarti, A., Chaloulos-Iakovidis, P., Chamorro, A., Chandrasena, D., Chang, D. I., Che, C., Chembala, J., Chen, J., Chen, Z., Chen, T., Chen, H., Chen, X., Chen, G., Chen, L., Chen, S., Cheripelli, B., Chin, M., Chiquete Anaya, E., Chorazy, M., Christensen, H., Christensen, T., Christian, L., Chu, F., Chung, C. S., Clark, W., Clarke, R., Claverie, S., Clemente Agostoni, E., Clissold, B., Coelho, J., Cohen, D., Colakoglu, S., Collas, D., Condurso, R., Consoli, D., Constantin, C., Constantino Silva, A. B., Contardo, L., Corlobe, A., Correia, M., Correia, C., Cortijo Garcia, E., Coull, B., Coutts, S., Coveney, S., Cras, P., Crols, R., Crozier, S., Csanyi, A., Csiba, L., Csontos, K., Csuha, R., Cui, L., Cunha, L., Curtze, S., Czerska, M., Czlonkowska, A., Czurko, M., Czuryszkiewicz, M., Dagnino, M., Dai, C., Daineko, A., Dalek, G., Damgaard, D., Danese, A., Dani, K., Danku, V., Dario Toledo, W., Davalos, A., De Havenon, A., De Keyser, J., De Klippel, N., De La Torre, J., De Pauw, A., De Smedt, A., De Torres, R., De Vries Basson, M. M., Dearborn, J., Deganutto, R., Degeorgia, M., Deguchi, I., Del Giudice, A., Delcourt, C., Delgado-Mederos, R., Della Marca, Giacomo, Delpont, B., Deltour, S., Demets, D. L., Dennis, M., Desai, J., Devine, J., Dhollander, I., Di Mascio, M. 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A., Gil Nunez, A., Gimenez, L., Giralt, E., Glabinski, A., Gladstone, D., Gliem, M., Gluszkiewicz, M., Goddeau, R., Gogoleva, E., Gokce, M., Goldemund, D., Golikov, K., Gomes Neto, A., Gomez Schneider, M., Gomez-Choco, M., Gomis, M., Gongora-Rivera, J. F., Gonysheva, Y., Gonzalez, L., Gonzalez Toledo, M. E., Gottschal, M., Gozdzik, I., Grabowski, S., Graf, S., Green, D., Greer, D., Gregorio, T., Greisenegger, S., Greshnova, I., Griebe, M., Grzesik, M., Guan, J., Guarda, S., Gueguen, A., Guidoux, C., Guillermo Povedano, P., Guillon, B., Guiraudg, V., Gunathilagan, G., Guryanova, N., Gusev, V., Gustavo Persi, G., Gutierrez, R., Guyler, P., Gyuker, N., Hachinski, V., Hajas, A., Hallevi, H., Hankey, G., Hankey, G. J., Hanouskova, L., Hao, L., Haraguchi, K., Haralur Sreekantaiah, Y., Haratz, S., Hargroves, D., Harkness, K., Harmel, P., Harrasser, M., Harvey, M., Hasan, R., Hasegawa, Y., Hassan, A., Hattori, M., Hatzitolios, A., Hauk, M., Hayashi, T., Hayhoe, H., Hedna, V. S., Heine, M., Held, V., Hellwig, S., Henkner, J., Henninger, N., Hermans, S., Hernandez, J., Herrero, D., Hervieu-Begue, M., Herzig, R., Hicken, L., Hieber, M., Hill, M., Hirose, M., Hobeanu, M. C., Hobson, B., Hochstetter, M., Hoe Heo, J., Hoffmann, M., Holmstedt, C., Hon, P., Hong, K. S., Honma, Y., Horev, A., Horgan, G., Horvath, L., Horvath, M., Hoyer, C., Huang, D., Huang, H., Huber, B., Huhtakangas, J., Hussain, M., Igarashi, S., Iglesias Mohedano, A. M., Ignacio Tembl, J., Impellizzeri, M., Inanc, Y., Ioli, P., Irina Aniculaesei, A., Ishida, K., Itabashi, R., Iversen, H., Jagolino, A., Jakab, K., Jander, S., Janka, H., Jankovych, J., Jansen, J., Jasek, L., Javier Alet, M., Javor, L., Jin, X., Jing, P., Joachim, B., Joan Macleod, M., Johnson, M., Jose Martin, J., Joyner, C., Judit Szabo, K., Jun-Oconnell, A., Jura, R., Kaczorowska, B., Kadlcikova, J., Kahles, T., Kakaletsis, N., Kakuk, I., Kalinowska, K., Kaminska, K., Kaneko, C., Kanellos, I., Kapeller, P., Kapica-Topczewska, K., Karasz, O., Karlinski, M., Karlsson, J. E., Kasa, K., Kashaeva, E., Kaste, M., Kasza, J., Katalin Iljicsov, A., Katsurayama, M., Kaur, S., Kawanishi, M., Kaygorodtseva, S., Ke, K., Kei, A., Keilitz, J., Kellner, J., Kelly, P., Kelly, S., Kemlink, D., Kerekgyarto, M., Keskinarkaus, I., Khairutdinova, D., Khanna, A., Khaw, A., Kholopov, M., Khoumri, C., Kirpicheva, S., Kirshner, H., Kitagawa, K., Kittner, S., Kivioja, R., Klein, F., Kleindorfer, D., Kleinig, T., Klivenyi, P., Knecht, S., Kobayashi, Y., Kobayashi, A., Koch, M., Koehler, L., Koivu, M., Kolianov, V., Koltsov, I., Kondo, T., Konkov, I., Kopecky, S., Korompoki, E., Korpela, J., Kosarz-Lanczek, K., Koutroubi, A., Kovacs, K., Kovacs, T., Kovacs, H., Kowalczyk, K., Kowalska, M., Krajickova, D., Kral, M., Krarup Hansen, C., Kraska, J., Krebs, S., Krejci, V., Kremer, C., Kreuzpointer, R., Krzyzanowska, M., Kucken, D., Kulakowska, A., Kunzmann, J., Kurenkova, N., Kuris, A., Kurkowska-Jastrzebska, I., Kurtenkova, N., Kurushina, O., Kusnick, G., Kustova, M., Kuwashiro, T., Kwan Cha, J., Lago, A., Lagutenko, M., Lajos, B., Lambeck, J., Lamy, C., Landolfi, A., Lanfranconi, S., Lang, W., Lara Lezama, L. 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E., Medlin, F., Mehdiratta, M., Mehta, S., Mehta, D., Mehta, B., Melis, M., Melnikova, E., Mendez, B., Mendonca, T., Mengual Chirifie, J. J., Menon, N., Mensch, A., Meseguer, E., Messe, S., Metcalf, K., Meyer, N., Michas, F., Micheletti, N., Mikulik, R., Milionis, H., Miller, B., Milling, T., Minelli, C., Minhas, J., Minns, M., Mircea, D., Mishra, S., Mismas, A., Mistri, A., Mitrovic, N., Miyake, H., Modrau, B., Moey, A., Molina, C., Molina, J., Molis, A., Moller, J., Molnar, S., Moniche, F., Monosi, C., Monzani, V., Moonis, M., Morais, R., Morales, L., Morales, A., Morar-Precup, D., Moreton, F., Moro, C., Morozova, E., Morton, M., Morvan, T., Morvan, E., Motko, T., Mowla, A., Mozhejko, E., Muddegowda, G., Mudhar, O., Mueller, T., Muhl, C., Muir, K. W., Munoz, S., Murphy, C., Murphy, S., Murtuzova, A., Musuka, T., Mutzenbach, J., Myint, M., Mysliwy, W., Naccarato, M., Naeije, G., Nagakane, Y., Natarajan, I., Navaratnam, D., Nave, A., Nazliel, B., Nedeltchev, K., Nel, J., Nell, H., Nemeth, R., Nemeth, L., Neto, O., Ng, K., Ngeh, J., Nicolas Chialvo, L., Nieminen, T., Nikkanen, M., Nikl, J., Nikoforova, M., Nishino, S., Nishiyama, Y., Njovane, X., Nogawa, S., Nombela, F., Norrving, B., Nosek, K., Nowak, B., Nowakowska-Sledz, E., Ntaios, G., Numminen, H., Nunez, F., Obadia, M., Oberndorfer, S., Obrezan, A., Ochiai, J., Oczkowski, W., O'Donnell, M. 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H., Ribeiro, J., Ricci, S., Richard, C., Rigual, R., Rinaldi, C., Riveira Rodriguez, C., Rizzato, B., Robinson, T. G., Rocco, A., Rodrigues, M., Rodriguez, G., Rodriguez Campello, A., Rodriguez Lucci, F., Rodriguez Yanez, M., Roesler, C., Roffe, C., Roine, R., Roine, S., Roldan, A., Romana Pezzella, F., Romano, M., Roos, J. 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F., Penn, A., Pentek, S., Pepper, E., Pereira, L., Perez, Y., Perez, S., Perez Leguizamon, P., Pernicka, M., Perry, R., Persico, A., Pesant, Y., Peska, S., Peters, D., Peters, G., Pettigrew, L., Phan, T., Philippi, S., Phinney, T., Pico, F., Pidal, A., Piechowski-Jozwiak, B., Pieroni, A., Pineiro, S., Piras, V., Pizova, N., Polanco, J., Polin, M., Polyakov, A., Polychronopoulou, E., Polymeris, A., Popov, D., Poppe, A., Postorino, P., Pozzerese, C., Pradhan, M., Prats, L., Prazdnichkova, E., Prendl, B., Pretorius, M., Profice, P., Prokopenko, S., Pudov, E., Pujol Lereis, V., Punzo Bravo, G., Purroy, F., Qiu, J., Qu, X., Quenardelle, V., Quesada Garcia, H., Radrizzani, L., Radtke, A., Raffelsberger, T., Ramirez Moreno, J. M., Ramos-Estebanez, C., Rani, A., Rapantova, P., Rashed, K., Rasheed Nihara, A., Rasmussen, J., Redondo Robles, L., Reif, M., Reiner, P., Rekova, P., Renu, A., Repetto, M., Reyes, P., Reyes Morales, S., Rha, J. H., Ribeiro, J., Ricci, S., Richard, C., Rigual, R., Rinaldi, C., Riveira Rodriguez, C., Rizzato, B., Robinson, T. G., Rocco, A., Rodrigues, M., Rodriguez, G., Rodriguez Campello, A., Rodriguez Lucci, F., Rodriguez Yanez, M., Roesler, C., Roffe, C., Roine, R., Roine, S., Roldan, A., Romana Pezzella, F., Romano, M., Roos, J. S., Rosso, C., Rostrup Kruuse, C., Roth, Y., Roukens, R., Roveri, L., Rozanski, D., Rozniecki, J., Rozsa, C., Rudilosso, S., Ruiz Ares, G., Ruiz Franco, A., Rum, G., Ruuskanen, J., Rybinnik, I., Ryota, K., Saarinen, J., Saavedra, V., Sabben, C., Sabet, A., Sagris, D., Sahlas, J., Sakai, N., Salamanca, P., Salgado, P., Salig, S., Salletmayr, T., Salnikov, M., Samoshkina, O., Samson, Y., Sanak, D., Sanchez Ceron, M., Santalucia, P., Santamaria Cadavid, M., Santiago, P., Sanz Cuesta, B., Sargento, J., Sarraj, A., Sas, K., Sas, A., Satoshi, O., Satsoglou, S., Sattar, N., Savitz, S., Savopoulos, C., Saw, J., Sawicka, M., Sawyer, R., Scandura, T., Schillinger, N., Schindler, J., Schlachetzki, F., Schneider, I., Schuppner, R., Schurig, J., Schwarzbach, C. J., Sebejova, M., Seidel, G., Sekaran, L., Selcuk, D., Selvarajah, J., Semerano, A., Semjen, J., Semushina, D., Sen, S., Seok Park, M., Serena, J., Serhat Tokgoz, O., Serles, W., Serrano, F., Sevin, M., Seynaeve, L., Shah, S., Shamalov, N., Shang, T., Sharrief, A., Shazam Hussain, M., Shchukin, I., Shen, W., Shepeleva, E., Shinsuke, I., Shmonin, A., Shuaib, A., Shulga, A., Sibolt, G., Sibon, I., Sicilia, I., Siebert, M., Sieczkowska, E., Sila, C., Silva, A. A., Silva, D., Silva, P., Silva, Y., Silvestrini, M., Simony, Z., Simpkins, A., Singh, B., Sinha, D., Sipos, I., Skoda, O., Skowron, P., Skowronska, M., Sliwinska, B., Slonkova, J., Smolkin, A., Smyth, A., Sobolewski, P., Sobota, A., Sohn, S. I., Soldatov, M., Solganov, I., Soloveva, L., Solovyeva, E., Sonntag, N., Soors, P., Sorgun, M., Soriano, C., Spence, D., Spengos, K., Sposato, L., Staaf, G., Stadler, K., Stakhovskaya, L., Stamatelopoulos, K., Steinert, S., Stetkarova, I., Stiehm, M., Stocker, R., Stoinski, J., Stoll, A., Stotts, G., Stumpp, A., Sucapane, P., Suenaga, T., Sun, X., Sundararajan, S., Sung Kim, J., Suzuki, H., Svaneborg, N., Szasz, G., Szczuchniak, W., Szczyrba, S., Szegedi, N., Szekely, A., Szewczyk, Z., Szilagyi, G., Szlufik, S., Szoboszlai, K., Szpisjak, L., Sztajzel, R., Sztriha, L., Ta Wil, S. E., Taggeselle, J., Takamatsu, K., Takao, M., Taki, W., Takizawa, S., Talahma, M., Tamayo, A., Tan, J., Tanne, D., Tapanainen, A., Tapiola, T., Tarasiuk, J., Tatlisumak, T., Tayal, A., Tcvetkova, S., Teal, P., Tejada Garcia, J., Tejada Meza, H., Tenora, D., Terceno, M., Terentiou, A., Tezcan, S., Thaler, D., Thomson, A., Thouvenot, E., Tiainen, M., Timberg, I., Timsit, S., Tinchon, A., Tirschwell, D., Togay Isikay, C., Tokunaga, K., Tolino, M., Toloza, C., Tomelleri, G., Tomoyuki, K., Tomppo, L. M., Tong, Z., Tong, L., Toni, D., Torres, J., Tossavainen, C., Toth, G., Tountopoulou, A., Touze, E., Tovar, M., Toyoda, K., Trillo, S., Trommer, A., Tropepi, D., Tryambake, D., Tu, H., Tuetuencue, S., Tumova, R., Tumpula, O., Turc, G., Tutaj, A., Tynkkynen, J., Uchiyama, S., Uchwat, U., Uhrinyakova, L., Ulku Acar, R., Uluduz Ugurlu, D., Urra, X., Urui, S., Usero Ruiz, M., Vaclavik, D., Vahedi, K., Valikovics, A., Valpas, J., Van Acker, P., Van Daele, W., Vanderschueren, G., Vanina Jure, L., Varela, R., Varga, Z., Varvat, J., Varvyanskaya, N., Vasco Salgado, A., Vasko, P., Vass, L., Vassilopoulou, S., Vastagh, I., Vazquez, P., Vecsei, L., Venti, M., Verdugo, M., Verocai, V., Veronica Marroquin, M., Veronica Simonsini, C., Veverka, T., Vigl, M., Vila, A., Vilar, C., Villanueva Osorio, J. A., Virta, J., Vitkova, E., Voglsperger, B., Volna, J., Von Weitzel-Mudersbach, P. A., Vora, N., Voznyuk, I., Wach-Klink, A., Wacongne, A., Walters, D., Wang, Y., Wang, J., Wang, L., Wang, X., Wang, W., Wang, N., Wang, D., Wang, H., Warnack, W., Wartenberg, K., Waters, R., Waters, M., Webb, T., Weber, J., Weiss, G., Weissenborn, K., Weitz, J. I., Weller, B., Wen, G., Weng, G., Werner, P., Werring, D., Wester, P., Whiteley, W., Whiting, R., Wijeratne, T., Willems, C., Wilson, L., Wilson, C., Winder, T., Windt, J., Winkler, A., Winska-Tereszkiewicz, A., Wisniewska, A., Wittayer, M., Wlodek, A., Wojnarowska-Arendt, A., Wolf, M., Wolff, V., Wolter, C., Wong, A., Wook Nah, H., Worthmann, H., Wu, W., Wu, S., Wunderlich, S., Wurzinger, H., Wyse, D. G., Xiao, B., Xiaopeng, W., Ximenez-Carrillo, A., Xiong, L., Xiong, Y., Xiong, W., Xu, Y., Xu, J., Xu, Z., Yalo, B., Yamada, T., Yamasaki, M., Yang, L., Yang, Y., Yang, X., Yang, Q., Yang, B., Yang, J., Yasuhiro, I., Yee Lam, M., Yegappan, C., Yip, S., Ylikallio, E., Ylikotila, P., Yongwon Jin, A., Yoon, B. W., Yoshida, Y., Yperzeele, L., Yuan, H., Yuasa, H., Zalewska, J., Zanferrari, C., Zapata, E., Zboznovits, D., Zelenka, I., Zhang, C., Zhang, B., Zhang, S., Zhang, M., Zhang, X., Zhang, J., Zhao, L., Zhirnova, O., Zhou, L., Zielinska-Turek, J., Zinchenko, I., Ziomek, M., Zitzmann, A., Zweifler, R., Zwiernik, J., and Della Marca G. (ORCID:0000-0001-6914-799X)

Abstract

Background: Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial. Methods: NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries that assessed the efficacy and safety of rivaroxaban versus aspirin for secondary stroke prevention in patients with ESUS. For this prespecified subgroup analysis, cohorts with and without PFO were defined on the basis of transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE). The primary efficacy outcome was time to recurrent ischaemic stroke between treatment groups. The primary safety outcome was major bleeding, according to the criteria of the International Society of Thrombosis and Haemostasis. The primary analyses were based on the intention-to-treat population. Additionally, we did a systematic review and random-effects meta-analysis of studies in which patients with cryptogenic stroke and PFO were randomly assigned to receive anticoagulant or antiplatelet therapy. Findings: Between Dec 23, 2014, and Sept 20, 2017, 7213 participants were enrolled and assigned to receive rivaroxaban (n=3609) or aspirin (n=3604). Patients were followed up for a mean of 11 months because of early trial termination. PFO was reported as present in 534 (7·4%) patients on the basis of either TTE or TOE. Patients with PFO assigned to receive aspirin had a recurrent ischaemic stroke rate of 4·8 events per 100 person-years compared with 2·6 events per 100 person-years in those treated with rivaroxaban. Among patients with known PFO, there was insufficient evidence to support a difference in risk o

Published
2018

15. A New Therapeutic Approach to Obesity: Stroke?

Author

Hasan Huseyin Kozak and Serhat Tokgoz

Subjects
medicine.medical_specialty, Nutrition and Dietetics, business.industry, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, medicine.disease, Obesity, 03 medical and health sciences, Therapeutic approach, 0302 clinical medicine, medicine, Surgery, Intensive care medicine, business, Stroke, 030217 neurology & neurosurgery
Published
2017

16. Clinical Properties of Regional Thalamic Hemorrhages

Author

Şeref Demirkaya, Mehmet Yücel, Semai Bek, Gençer Genç, Tayfun Kasikci, Zeki Odabasi, and Serhat Tokgoz

Subjects
Male, medicine.medical_specialty, Thalamus, Thalamic Diseases, Dysarthria, Aphasia, Diabetes mellitus, medicine, Humans, Aged, Cerebral Hemorrhage, Aged, 80 and over, business.industry, Rehabilitation, Glasgow Coma Scale, Retrospective cohort study, Middle Aged, medicine.disease, Surgery, medicine.anatomical_structure, Diabetes Mellitus, Type 2, Ventricle, Hypertension, Thalamic hemorrhage, Female, Neurology (clinical), medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract

Background Thalamic hemorrhage constitutes 6% to 25% of intracerebral hemorrhages. Vascular lesions affecting the thalamus may cause a variety of clinical symptoms. This retrospective study aims to evaluate localization of hemorrhage and clinical symptoms in patients with thalamic hemorrhage. Methods One hundred and one patients with thalamic hemorrhage were examined retrospectively in our department. Hemorrhages were classified into 5 groups according to computed tomography: medial (thalamoperforate), anterolateral (tuberothalamic), posterolateral (thalamogeniculate), dorsal (posterior choroidal), and global. The relation between volume, localization, and penetration to adjacent structures/ventricles of hemorrhage and risk factors, clinical features, and prognosis were evaluated. Results The study group included 101 patients. Eighty-two percent of the patients had hypertension, 19.8% had diabetes mellitus, 14.9% had cardiac disease, and 5.9% had chronic renal failure. Mean blood pressure was 173/101 mm Hg. Decreased Glasgow coma scale was significantly higher in the global hemorrhage group than in all regional groups (Chi-square, 10.54; P = .002). Medial group hemorrhages had a significantly higher rate than anterolateral, posterolateral, and dorsal intraventricular expansion. Out of speech disorders, 49% of patients had a right thalamic lesion (especially dysarthria) and 51% of patients had a left thalamic lesion (mostly aphasia). Conclusions In the study, we detected that the most important risk factor in thalamic hemorrhage is hypertension. The prognosis is worse in global and medial group hemorrhages, especially those which rupture to the ventricle, than the other groups. Thalamic lesions cause a variety of symptoms, including forms of aphasia, such as crossed dextral aphasia.

Published
2013

17. Perfusion-weighted cranial MR imaging findings in a patient with hemophagocytic lymphohistiocytosis

Author

Orhan Demir, Muzaffer Mutluer, Yahya Paksoy, Huseyin Tokgoz, and Serhat Tokgoz

Subjects
Hemophagocytic lymphohistiocytosis, Radiological and Ultrasound Technology, business.industry, Perfusion weighted, medicine, Radiology, Nuclear Medicine and imaging, Neurology (clinical), medicine.disease, Nuclear medicine, business, Mr imaging, Neuroradiology
Abstract

Journal of Neuroradiology - In Press.Proof corrected by the author Available online since jeudi 21 fevrier 2013

Published
2013

18. TAFI gene polymorphisms in patients with cerebral venous thrombosis

Author

Nurhan Ilhan, Mithat Tavli, Alper Sinan, Osman Yılmaz, Sennur Demirel, Ayse Gul Zamani, Serhat Tokgoz, and Hatice Gul Durakbasi-Dursun

Subjects
Adult, Male, medicine.medical_specialty, Neurology, Genotype, medicine.medical_treatment, DNA Mutational Analysis, Gastroenterology, Young Adult, Thrombin, Gene Frequency, Internal medicine, Fibrinolysis, medicine, Humans, Thrombus, Allele, Histone Acetyltransferases, TATA-Binding Protein Associated Factors, Chi-Square Distribution, Polymorphism, Genetic, business.industry, General Medicine, Middle Aged, medicine.disease, Cerebral Veins, Venous thrombosis, Case-Control Studies, Anesthesia, Etiology, Female, Transcription Factor TFIID, Neurology (clinical), Intracranial Thrombosis, Tomography, X-Ray Computed, business, Magnetic Resonance Angiography, medicine.drug
Abstract

Gene polymorphisms of thrombin activatable fibrinolysis inhibition (TAFI) factor have been investigated in various studies in terms of etiology (recurrence) and treatment (fibrinolytic effect) of thrombus formation. Cerebral venous thrombosis (CVT) is a life-threatening disease observed in young persons. Fifty-nine patients with CVT and 100 healthy control subjects were enrolled in the case/control study. The association between TAFI gene polymorphisms -438G > A, +505A > G and +1040C > T and cerebral venous thrombosis was investigated. It was found that frequencies of polymorphic genotype and allele were not different in patients than in control group and that they were not significant for cerebral venous thrombosis.

Published
2012

19. The Correlation Between Smoking Status of Family Members and Concentrations of Toxic Trace Elements in the Hair of Children

Author

Serhat Tokgoz, Cem Hasan Razi, Beril S. Akin, Osman Aykut, Levent Kenar, Okhan Akin, and Muhittin Serdar

Subjects
Male, Smoking habit, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, chemistry.chemical_element, Family income, Biochemistry, Inorganic Chemistry, Environmental health, Humans, Family, Child, Cadmium, Clinical screening, Smoking, Biochemistry (medical), Hair analysis, Metallurgy, Total income, Trace element, Infant, General Medicine, Trace Elements, Cross-Sectional Studies, chemistry, Child, Preschool, Female, Tobacco Smoke Pollution, Smoking status, Hair
Abstract

Hair analysis is a promising tool for routine clinical screening and diagnosis of heavy metal exposure and essential trace element status in the human body. Systemic intoxications have been identified by anomalously high values of toxins in hair samples. The aim of the present study is to evaluate the relationship between smoking habit of the family members and the levels of toxic and nontoxic trace elements in hair samples of children. The randomized cross-sectional controlled study comprised of 95 children (41 girls and 54 boys) between the ages of 1 and 6 years. After written informed consent was obtained, a face-to-face interview was conducted with the families about educational background, total income of the family, and smoking habits of family members. The mineral elements considered in this study were Zn, Se, B, V, Co, Mo, Mn, iron (Fe), Be, aluminum (Al), As, cadmium (Cd), lead (Pb), Hg, chromium (Cr), Ag, Be, nickel (Ni), copper (Cu), Sn, and antimony (Sb). Hair mineral contents were measured by inductively coupled plasma-mass spectrometry. The results showed that the levels of Cd, Pb, Cr, Sb, Fe, and Al in hair samples of children whose parents smoked were significantly higher than those whose parents were nonsmokers. The number of smokers and the frequency of smoking at home were positively correlated with Pb, Cd, Cu, Ni, and Sb levels found. At the same time, it was found that there was no correlation between toxic element concentrations and family income or educational background excluding the levels of Cd. A correlation was observed between the smoking status of family members and levels of toxic trace elements in hair where this correlation was more significant with the levels of Pb and Cd. High socioeconomic status and the level of education of family members did not have any effect on toxic trace levels in hair samples of children.

Published
2012

20. P-wave Dispersion for Predicting Paroxysmal Atrial Fibrillation in Acute Ischemic Stroke

Author

Umuttan Dogan, Ebru Apaydin Dogan, Mehmet Tekinalp, Osman Serhat Tokgoz, Alpay Aribas, Hakan Akilli, Kurtulus Ozdemir, Hasan Gok, Betigul Yuruten

Subjects
lcsh:R, lcsh:Medicine, cardiovascular diseases
Abstract

Background: Detection of paroxysmal atrial fibrillation (PAF) in acute ischemic stroke patients poses diagnostic challenge. The aim of this study was to predict the presence of PAF by means of 12-lead ECG in patients with acute ischemic stroke. Our hypothesis was that P-wave dispersion (Pd) might be a useful marker in predicting PAF in patients with acute ischemic stroke.Methods: 12-lead resting ECGs, 24-hour Holter recordings and echocardiograms of 400 patients were analyzed retrospectively. PAF was detected in 40 patients on 24-hour Holter monitoring. Forty out of 360 age and gender matched patients without PAF were randomly chosen and assigned as the control group. Demographics, P-wave characteristics and echocardiographic findings of the patients with and without PAF were compared.Results: Maximum P-wave duration (p=0.002), Pd (pd was the only independent predictor of PAF. The cut-off value of Pd for the detection of PAF was 57.5 milliseconds (msc). Area under the curve was 0.80 (pConclusion: Pd on a single 12-lead ECG obtained within 24 hours of an acute ischemic stroke might help to predict PAF and reduce the risk of recurrent strokes.

Published
2012

21. Mood and anxiety disorders in patients with multiple sclerosis

Author

Ishak Ozkan, Faruk Uguz, Serhat Tokgoz, and Zehra Akpinar

Subjects
medicine.medical_specialty, Generalized anxiety disorder, Exacerbation, Panic disorder, medicine.disease, behavioral disciplines and activities, Specific phobia, Psychiatry and Mental health, Prevalence of mental disorders, Mood, mental disorders, medicine, Anxiety, medicine.symptom, Psychology, Psychiatry, Anxiety disorder
Abstract

Objective. This study aims to investigate the current prevalences of mood and anxiety disorders, as well as the sociodemographic and clinical features associated with these disorders in multiple sclerosis (MS). Method. A total of 74 patients with relapsing-remitting MS (42 patients in exacerbation phase, 32 patients in remission phase) were included in the study. Mood and anxiety disorders were diagnosed by means of the Structured Clinical Interview for DSM-IV (SCID-I). The Expanded Disability Status Scale (EDSS) was used to determine degree of disability due to MS. Results. Forty-five (60.8%) patients met the criterion of at least one mood or anxiety disorder. Major depression (33.8%) was the most common psychiatric diagnosis. Generalized anxiety disorder (18.9%), specific phobia (18.9%) and obsessive-compulsive disorder (OCD) (14.9%) were other frequent psychiatric disorders. Major depression, panic disorder and OCD were significantly more common among patients in the exacerbation phase compared to patients in the remission phase. The predictors of any depressive disorder were presence of exacerbation phase of MS and higher disability level, and the predictors of any anxiety disorder were presence of exacerbation phase of MS and shorter disease duration. Conclusions. Our results suggest that the patients with relapsing-remitting MS, particularly during exacerbation phase have high prevalence of mood and anxiety disorders.

Published
2008

22. The effect of silymarin on hepatic regeneration after partial hepatectomy: is silymarin effective in hepatic regeneration?

Author

Suleyman, Cetinkunar, Serhat, Tokgoz, Bulent Caglar, Bilgin, Hasan, Erdem, Recep, Aktimur, Serpil, Can, Huseyin Serkan, Erol, Atilla, Isgoren, Selim, Sozen, and Yilmaz, Polat

Subjects
Original Article
Abstract

Aim: Silymarin from Silybum marianum was found to reduce liver injury. The aim of the present study was to investigate the effects of silymarin on hepatic regeneration in partially hepatectomized rats. Methods: Thirty Wistar-Albino rats were divided into 3 groups of 10 animals as sham, control and experimental groups. In the sham group (n=10) abdominal incision was closed after laparotomy. In the control group (n=10), the rats underwent 70% hepatectomy after laparotomy. In the experimental group (n=10) after partial 70% hepatectomy, silymarin (200 mg/kg/d) were given to rats for 10 days. Rats in three groups were sacrificed on 10 days. Aspartate (AST) and alanine transaminase (ALT), gamma glutamyl transferase (GGT), ALP, LDH and total bilirubin levels were measured using intracardiac blood samples. Tissue malondialdehyde (MDA) and tissue glutathion (GSH) and Superoxide dismutase (SOD) levels were measured. To reveal the increase in the mass of the remnant liver tissue in the control and experimental groups relative weight of the liver was calculated. Histopathological analysis of the liver was performed using a semi-quantitative scoring system. Results: A statistically significant difference among three groups was not shown for AST and ALT levels. A statistically significant difference was found between the groups as for total bilirubin and gamma glutamyl transferase levels. Increases in relative liver weights were seen with time in Groups 2 and 3. A statistically significant difference was not found for tissue malondialdehyde, Glutathion and Superoxide dismutase levels between hepatectomy and hepatectomy + silymarin groups. On liver tissue sections of the rats in the hepatectomy + silymarin group, increased regeneration and lipid peroxidation were observed accompanied by decreased antioxidant response. Conclusion: It has been observed that silymarin with many established functions such as antiproliferative, anti-inflammatory and energy antioxidant effects, does not contributed to proliferative regeneration of the liver-which has very important metabolic functions -after partial hepatectomy; instead it will decrease serum levels of transaminases.

Published
2014

23. Concomitant neuromyelitis optica and cytomegalovirus-associated retinitis in an immunocompetent female

Author

Serhat Tokgoz, Nurhan İlhan, Onur Ural, Haluk Gumus, and Ebru Apaydın Doğan

Subjects
Foscarnet, medicine.medical_specialty, Neurology, Neuromyelitis optica, business.industry, Congenital cytomegalovirus infection, Retinitis, General Medicine, medicine.disease, Dermatology, Concomitant, Medicine, Optic neuritis, Neurology (clinical), business, Neuroradiology, medicine.drug
Published
2013

24. Effects of chronic ethanol administration and ethanol withdrawal on cyclic guanosine 3′,5′-monophosphate (cGMP) levels in the rat brain

Author

Hakan Kayir, I. Tayfun Uzbay, Cumhur Bilgi, Ahmet Aydin, Serhat Tokgoz, and Turgay Celik

Subjects
medicine.medical_specialty, Liquid diet, Central nervous system, Hippocampus, Striatum, Toxicology, chemistry.chemical_compound, Cortex (anatomy), Internal medicine, medicine, Animals, Pharmacology (medical), Rats, Wistar, Cyclic GMP, Pharmacology, Ethanol, Brain, Rats, Substance Withdrawal Syndrome, Psychiatry and Mental health, Endocrinology, medicine.anatomical_structure, nervous system, chemistry, Hypothalamus, Cerebral cortex, Anesthesia, Female, Psychology
Abstract

The main objective of the present study is to investigate the possible effects of chronic ethanol consumption and ethanol withdrawal on cyclic guanosine 3′, 5′-monophosphate (cGMP) levels in cerebral cortex, striatum, hippocampus and hypothalamus of rat brain. Ethanol was given to female Wistar rats (225–270 g) by a liquid diet for 21 days. cGMP levels were measured in respective brain regions using an EIA kit at 7th, 14th and 21st days of ethanol ingestion and at 6th and 24th h of ethanol withdrawal. cGMP levels in cortex, striatum and hippocampus but not hypothalamus were found significantly increased at 14th and 21st days of ethanol consumption. The most prominent increase was observed in striatal tissues (approximately 350%). cGMP levels of striatum and hippocampus were still remaining significantly high at 6th h of ethanol withdrawal. Blood ethanol levels were found as 115.60, 50.0 and 7.0 mg/dl just before and after 6 and 24 h of ethanol withdrawal, respectively and audiogenic seizures also occurred at 6th h of ethanol withdrawal with an incidence of 75% in individual parallel groups. Our results suggest that changes of cGMP levels in cerebral cortex, striatum and hippocampus might participate in the mechanism of ethanol dependence and withdrawal in rats.

Published
2004

25. C-Reactive protein on admission and the success of thrombolytic therapy with streptokinase: is there any relation?

Author

Hurkan Kursaklioglu, Sedat Kose, Ersoy Isik, Basri Amasyali, Atila Iyisoy, Nadir Barindik, Ayhan Kilic, Serhat Tokgoz, Ertan Demirtaş, and Cem Barçın

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Streptokinase, Myocardial Infarction, Fibrinolytic Agents, Internal medicine, Angioplasty, Fibrinolysis, medicine, Humans, Thrombolytic Therapy, Myocardial infarction, Angioplasty, Balloon, Coronary, Aged, biology, business.industry, C-reactive protein, Middle Aged, medicine.disease, C-Reactive Protein, Treatment Outcome, medicine.anatomical_structure, Atheroma, Regional Blood Flow, Cardiology, biology.protein, Female, Stents, Cardiology and Cardiovascular Medicine, business, TIMI, Artery, medicine.drug
Abstract

Recent evidence has demonstrated that inflammation plays a major role in the initiation and progression of atheroma plaques. C-reactive protein (CRP) is shown to have prognostic significance in acute coronary syndromes. We investigated the influence of CRP levels before thrombolytic therapy on infarct-related artery (IRA) patency and the degree of residual stenosis.45 consecutive patients with a first attack of acute myocardial infarction (MI) who underwent streptokinase therapy and subsequently coronary angiography were enrolled into the study. Patients were divided into 2 groups according to the level of CRP on admission.Serum CRP levels wereor =0.5 mg/dL in 26 patients (Group-I) and0.5 mg/dL in 19 patients (Group-II). The patency of IRA (TIMI-2 and 3) evaluated at 90th minute after the initiation of thrombolytic therapy was similar between the two groups (62% vs. 68%, p0.05). However, the presence of TIMI-3 flow was significantly lower and TIMI-2 flow was higher in Group-I as compared to Group-II (12% vs. 53%, p=0.003 and 50% vs. 16%, p=0.018 respectively). Additionally, among patients with patent IRA, the degree of residual stenosis was significantly higher in Group-I (80 +/- 14% vs. 68 +/- 15%, p=0.032).High serum CRP levels on admission in patients within 6 hours after the start of acute ST-segment elevation MI are associated with lower TIMI flow grades and higher residual stenosis of IRA after intravenous streptokinase. Our observations imply that patients with higher CRP levels on admission require closer follow-up during and after acute MI.

Published
2003

26. Neutrophil lymphocyte ratio as a predictor of stroke

Author

Betigül Yürüten, Zehra Akpinar, Mehmet Kayrak, Figen Güney, Serhat Tokgoz, and Abdullah Seyithanoğlu

Subjects
Adult, Male, medicine.medical_specialty, Neutrophils, Gastroenterology, Risk Assessment, Sensitivity and Specificity, Coronary artery disease, Leukocyte Count, Interquartile range, Internal medicine, medicine, Humans, Lymphocytes, Prospective Studies, Neutrophil to lymphocyte ratio, Stroke, Aged, Aged, 80 and over, business.industry, Proportional hazards model, fungi, Rehabilitation, Hazard ratio, Retrospective cohort study, Middle Aged, medicine.disease, Prognosis, Confidence interval, Surgery, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, business
Abstract

Background The aim of this study is to investigate the relationship of the neutrophil to lymphocyte ratio (NLR) with short-term mortality in acute stroke. Methods This retrospective study included 255 patients with acute cerebral infarction who presented within 24 hours of symptom onset. A hemogram from peripheral venous blood samples was taken at the time of admission. The NLR was calculated as the ratio of neutrophils to lymphocytes. Duration of follow-up was defined as 60 days. Results Seventy-one of 255 patients died during the follow-up period. The median NLR was significantly increased among the mortality group compared with the survival group (median 11.50, interquartile ratio [IQR] 10.40 vs median 3.79, IQR 4.72; P = .001). In our multivariate Cox regression model, NLR >5.0 (hazard ratio [HR] 3.30; 95% confidence interval [CI] 1.35-8.07), National Institutes of Health Stroke Scale score (HR 1.11; 95% CI 1.07-1.16), glucose values at admission (HR 1.007; 95% CI 1.002-1.011), and history of coronary artery disease (HR 2.49; 95% CI 1.26-4.92) were predictors of short-term mortality. The sensitivity for short-term mortality when the NLR was >5 was 83.10%, and the specificity was 62.00%. The positive predictive value of a NLR >5 was 45.7%, and negative predictive value was 90.50%. A strong linear association between NLR and National Institutes of Health Stroke Scale score was also observed (r = 0.64; P = .001). In addition, the NLR was higher in both the atherosclerotic and cardioembolic stroke subgroups than the lacunar infarct subgroup (6.5 [IQR 7.2], 7.5 [IQR 8.9], and 3.20 [IQR 3.50], respectively; P = .001). Conclusions The NLR at the time of hospital admission may be a predictor of short-term mortality in acute stroke patients. Because of the routine use and inexpensive nature of hemogram analysis, the NLR should be investigated in future prospective, randomized controlled trials investigating acute stroke.

Published
2012

27. Role of Intraoperative Nerve Monitoring in Postoperative Muscle and Nerve Function of Patients Undergoing Modified Radical Mastectomy

Author

Serhat Tokgöz, Ebru Karaca Umay, Kerim Bora Yilmaz, Muzaffer Akkoca, Melih Akinci, Cem Azili, Mehmet Saydam, Yasin Ucar, and Şener Balas

Subjects
breast cancer, electromyography, intraoperative nerve monitoring, muscle ultrasound, Surgery, RD1-811
Abstract

This study aimed to postoperatively evaluate the effects of intraoperative neural monitoring (IONM) on muscles and nerves in patients who underwent modified radical mastectomy (MRM). In the 11 patients included in the study, nerves were determined and protected by nerve monitoring during the axillary dissection (IONM group). In another 11 patients, nerve monitoring was not performed; however, protection of the same nerves was attempted through careful nerve dissection (cautious nerve dissection [CND] group). The control group consisted of 22 healthy subjects. Muscle and nerve functions were blindly evaluated by an experienced physical therapy and rehabilitation specialist using electromyography (EMG) and ultrasonography (US) methods. The EMG values of the pectoralis major muscle were similar in the IONM and control groups (1.97 mV/1.98 mV, p = 0.97) but significantly lower in the CND group (1.57 mV, p

Published
2021
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28. Frequency, severity and risk factors for restless legs syndrome in healthcare personnel

Author

Selma, Civi, Ruhusen, Kutlu, and Serhat, Tokgoz

Subjects
Adult, Male, Health Personnel, Age Factors, Middle Aged, Severity of Illness Index, Young Adult, Cross-Sectional Studies, Sex Factors, Risk Factors, Restless Legs Syndrome, Odds Ratio, Humans, Female
Abstract

To evaluate the frequency, severity, and risk factors for restless legs syndrome (RLS) in healthcare personnel.This cross-sectional study was performed at the Outpatient Family Medicine Clinic of Meram Medical Faculty in Konya, Turkey and included 354 healthcare personnel who were working at the Meram Medical Faculty Hospital between October 2010 and June 2011. The International RLS (IRLS) rating scale was used to calculate RLS severity. The RLS symptoms positive patients were investigated for neurological examination.Of all the participants, 277 (78.2%) were female. The overall prevalence of RLS according to the 4 essential criteria in the participating healthcare personnel was 15% (n=53) (16.9% male, 14.4% female). Gender (p=0.726) and age (p=0.197) were not significantly related to RLS. According to the International Restless Legs Syndrome Study Group (IRLSSG) the severity scale for RLS, of the RLS positive patients, 16% were classified as mild (n=8), 40% as moderate (n=21), and 44% as severe (n=24). Approximately, 54.7% of 53 RLS patients had a positive family history of the disorder.Restless leg syndrome is a treatable disorder; however, it is still widely misdiagnosed by physicians. The history of the patient and family is very important in the diagnosis of RLS.

Published
2012

29. Cerebral Abscesses in Behcet's Disease: A Case Report

Author

Muzaffer Mutluer, Aysegul Ogmegul, Serhat Tokgoz, Ali Sami Kivrak, Mehmet Erkan Ustun, and Selçuk Üniversitesi

Subjects
Male, medicine.medical_specialty, medicine.drug_class, Biopsy, Antibiotics, Brain Abscess, Disease, Behcet's disease, Medicine, Humans, Abscess, Neurologic Examination, medicine.diagnostic_test, business.industry, Behcet Syndrome, Magnetic resonance imaging, Middle Aged, medicine.disease, Dermatology, Magnetic Resonance Imaging, Anti-Bacterial Agents, NeuroBehcet disease, Etiology, Cerebral abscess, Surgery, Neurology (clinical), Epileptic seizure, Epilepsies, Partial, medicine.symptom, business
Abstract

WOS: 000300031600022, PubMed: 22274984, Behcet's disease is a multisystem relapsing inflammatory disorder of unknown cause. Neurological involvement is one of the most serious causes of long-term morbidity and mortality in Behcet's disease. Cerebral abscess is very rare in literature. A 45-yr-old man with Behcet's disease manifesting focal epileptic seizure and multiple cerebral abscesses is reported in the case. He was diagnosed with cerebral abscess and was treated with antibiotics but no improvement occurred. Excisional biopsy was performed and the lesions were consistent with abscess. The clinical state of the patient gradually improved. The patient had no further complications. The etiology, and clinical and magnetic resonance imaging findings are discussed.

Published
2012

31. The association of nocturnal serum melatonin levels with major depression in patients with acute multiple sclerosis

Author

Gülsüm Yılmaz, Zehra Akpinar, Hakkı Gökbel, Serhat Tokgoz, Nilsel Okudan, and Faruk Uguz

Subjects
Adult, Male, medicine.medical_specialty, Multiple Sclerosis, Comorbidity, Nocturnal, Gastroenterology, Melatonin, Central nervous system disease, Disability Evaluation, Internal medicine, medicine, Humans, In patient, Circadian rhythm, Biological Psychiatry, Depression (differential diagnoses), Depressive Disorder, Major, business.industry, Multiple sclerosis, Middle Aged, medicine.disease, Circadian Rhythm, Psychiatry and Mental health, Endocrinology, Acute Disease, Female, business, medicine.drug
Abstract

The association of nocturnal serum melatonin levels was investigated in acute multiple sclerosis (MS) patients with major depression (MD). The sample comprised 13 patients with MD and 12 with no psychiatric disorders admitted to our clinic due to acute MS attacks. Psychiatric evaluation was performed with the Structured Clinical Interview for DSM-IV (SCD-I). The level of depressive symptoms was assessed with the Beck Depression Scale (BDS). Blood samples were taken from the patients to determine melatonin level at 03.30 h and 10.00 h before steroid treatment started. Melatonin levels were determined using the ELISA test. Nocturnal serum melatonin levels (21.2+/-17.1 pg/ml) of the patients with MD were significantly lower than those (51.5+/-18.3 pg/ml) of the patients without MD. A significant negative correlation was found between BDS scores and nocturnal serum melatonin levels. These findings suggest that a melatonin deficiency may be among the factors involved in the occurrence of depression in MS patients.

Published
2007

32. Effect of macro-creatine kinase and increased creatine kinase BB on the rapid diagnosis of patients with suspected acute myocardial infarction in the emergency department

Author

Gurkan Metinyurt, Cumhur Bilgi, Muhittin Serdar, Türker Kutluay, Serhat Tokgoz, Serkan Tapan, Levent Kenar, Adnan Haşimi, and Kürşat Erinç

Subjects
Adult, Male, medicine.medical_specialty, Myocardial Infarction, Increased creatine kinase, Hospitals, Military, Sensitivity and Specificity, Electrocardiography, Predictive Value of Tests, Internal medicine, Creatine Kinase, BB Form, medicine, Humans, Myocardial infarction, Intensive care medicine, Creatine Kinase, Aged, Aged, 80 and over, biology, medicine.diagnostic_test, business.industry, Public Health, Environmental and Occupational Health, General Medicine, Emergency department, Middle Aged, medicine.disease, Isoenzymes, Predictive value of tests, Cardiology, Macro-Creatine Kinase, biology.protein, Creatine kinase, Female, Myocardial infarction diagnosis, business, Emergency Service, Hospital, Biomarkers
Abstract

Although there are more sensitive and earlier diagnostic markers for the diagnosis of acute myocardial infarction (AMI), measurement of creatine kinase (CK) MB isoenzyme (CKMB) using the immunoinhibition method is still widely used in stat laboratories. In this study, 3,290 patients with the prediagnosis of AMI underwent physical examinations, electrocardiography, and repetitive measurements of CK, CKMB activity, and CKMB mass, and 304 of them were diagnosed as having AMI. Electrophoresis of CK and CKMB mass was performed for the samples from 415 patients whose CKMB activity values were found to be increased and were not correlated with total CK levels. According to CKMB activity, CK electrophoresis, and CKMB index (100 x CKMB activity/CK) values, macro-CK (MCK) and/or increased CKBB levels were detected in 27 cases (MCK-I in 10 cases, MCK-II in 9, increased CKBB in 5, and both MCK-II and increased CKBB in 3). CKMB activity was found to be increased for all except one patient (96.3%), and the CKMB index was >25% in 25 (92.5%) of 27 cases. CKMB mass values were within the normal range in 25 of the cases with MCK. Two patients with MCK-I were diagnosed as having AMI because of increased CKMB mass and positive electrocardiography findings. The incidence of MCK and/or high CKBB levels (0.82%) in the whole group was similar to that reported for a normal population. MCK existence and increased CKBB levels may cause misleading diagnoses if CKMB mass measurements and/or CKMB index values are not used together for patients with suspected AMI.

Published
2005

33. The effects of chronic ethanol consumption and ethanol withdrawal on serum cholinesterase activity in rats

Author

Ahmet Aydin, Serhat Tokgoz, I. Tayfun Uzbay, Turgay Celik, and Cumhur Bilgi

Subjects
medicine.medical_specialty, Liquid diet, Alcohol Drinking, Physical dependence, chemistry.chemical_compound, Internal medicine, medicine, Ingestion, Animals, Cholinesterases, Rats, Wistar, Butyrylcholinesterase, Cholinesterase, Ethanol, biology, Chemistry, General Medicine, medicine.disease, Rats, Substance Withdrawal Syndrome, Enzyme Activation, Endocrinology, Anesthesia, Alcohol withdrawal syndrome, Toxicity, biology.protein, Female, medicine.symptom
Abstract

Aims: The effect of chronic ethanol consumption and ethanol withdrawal on serum cholinesterase (ChE) activity was investigated in female Wistar rats. Methods: Ethanol was administered by a modified liquid diet with 4.8% (v/v) ethanol for 3 days followed by 25 days on a liquid diet in which the ethanol concentration was increased to 7.2%. Control rats were pair-fed with an isocaloric liquid diet not containing ethanol. The blood ethanol concentration and serum ChE activity were measured at the end of the 4.8% ethanol consumption period; after 7, 14 and 35 days of ethanol (7.2%) consumption, and at 24 and 72 h after ethanol withdrawal following ethanol consumption of 35 days. Results: Daily ethanol consumption of the rats ranged from 11.5 to 14.9 g/kg. Serum ChE activity was found significantly increased from the 3rd day of ethanol (4.8%) consumption. Serum ChE activities of the rats receiving 7.2% ethanol also increased significantly compared with rats ingesting 4.8% ethanol. Blood ethanol levels were measured as 121 and 0.88 mg/dl on the 35th day of ethanol (7.2%) consumption (just before ethanol withdrawal) and after 24 h of ethanol withdrawal, respectively. Increased serum ChE activity (1968 U/l) was still observed (1942 U/l) after 24 h of ethanol withdrawal. ChE activity returned to control levels (501 U/l) after 72 h of ethanol withdrawal. Audiogenic seizures indicating development of physical dependence on ethanol were also observed after 8 h of ethanol withdrawal in another individual group of ethanol-fed rats. Conclusions: Our results show that serum ChE activity is increased by chronic ethanol consumption in rats and that this increase is affected by ethanol concentration and duration of ethanol ingestion.

Published
2003

34. Predictive Factors of Thyroid Cancer in Geriatric Patients

Author

Serhat Tokgöz and Harun Karabacak

Subjects
thyroid cancer, geriatric, elastography, irregular margins, microcalcification, Medicine, Medicine (General), R5-920
Abstract

Aim:Although age is not a contraindication for thyroid surgery, decision for surgery should be made carefully in geriatric patients. The aim of this study was to determine the diagnostic value of cytological and ultrasonographic findings in geriatric patients with thyroid pathology.Methods:Records of patients above 65 years, who underwent thyroid surgery in our clinic between 2014 and 2019, were retrospectively analyzed. Demographic data, biopsy findings according to the Bethesda System, ultrasonography findings (nodule size, echogenicity, margin, micro-calcification, elastography values, peripheral halo and its echogenicity) and pathology results were recorded.Results:A total of 295 patients (58 males and 237 females) with the mean age of 69.13 years (range; 65-82) were included in the study. When benign and malignant groups were compared, suspicion of malignancy, presence of irregular margins, micro-calcification, elastography score of above 3, hypo-echogeneicity and hypo-echoic halo were found to be significant predictive factors for malignancy (p

Published
2020
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35. Invasive Management of Abscess Due to Splenic Infarct: A Retrospective Analysis of Thirteen Cases

Author

Harun Karabacak, Selim Tamam, Şener Balas, Serhat Tokgöz, Kerim Bora Yılmaz, Melih Akıncı, Onur Ergün, Hasan Ali Durmaz, Metin Aydın, Muzaffer Akkoca, and Cem Azılı

Subjects
splenic infarct, abdominal pain, splenectomy, splenic abscess, Medicine, Medicine (General), R5-920
Abstract

Aim:Splenic infarction is a rare condition successfully treated with medical methods in general. The aim of this study was to evaluate the invasive treatment options in patients with splenic infarction-associated abscess.Methods:Files of thirteen patients, who underwent percutaneous drainage or a surgical procedure due to abscess as a result of splenic infarction, were retrospectively reviewed. Age symptoms, results of physical and radiological examinations and therapeutic methods were analyzed.Results:A total of 13 patients with the mean age of 56±18 years were included in the study. Seven (54%) patients were female and six (46%) were male. Acute abdomen was observed in 11 patients (85%), and acute abdomen as well as high white blood cell (WBC) count (>15000/mL) in nine patients (70%). Percutaneous drainage was performed in five patients (39%) and splenectomy in eight patients (62%), all of whom were diagnosed with splenic abscess by means of computed tomography. There was no difference in age, gender, acute abdomen, WBC count, platelet count and mortality between patients who underwent splenectomy and percutaneous drainage group, whereas in the splenectomy group, the number of associated diseases was higher and the length of hospital stay was longer (p=0.017 and p=0.011, respectively).Conclusion:Percutaneous drainage and, when necessary, splenectomy should be performed in patients who develop abscess as a result of splenic infarct, whose general health conditions deteriorates and whose symptoms do not improve and who have high WBC count despite medical treatment.

Published
2019
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36. The effect of lateral pectoral nerve sparing technique and radiotherapy on the pectoralis major muscle applied with modified radical mastectomy

Author

Muzaffer Akkoca, Mehlika Panpallı Ateş, Kerim Bora Yılmaz, İnanç İmamoğlu, Şener Balas, Serhat Tokgöz, Melih Akıncı, Harun Karabacak, and Ece Ünlü

Subjects
Surgery, RD1-811
Abstract

Summary: Background/Objective: The aim of this study was to evaluate with electromyography (EMG) the effect of lateral pectoral nerve sparing technique (LPNST) and radiotherapy (RT) on the lateral pectoral nerve (LPN) in patients applied with modified radical mastectomy (MRM). Methods: The study included 66 patients who underwent MRM surgery. The patients were separated into 2 groups as those applied with LPNST and those who underwent standard surgery (Control group). Within these 2 groups, patients were again separated as those who received or did not receive RT. The EMG evaluations were made by a neurology specialist blinded to the patient groups. Results: The mean age of the patients was 53.3 ± 10.6 years. Standard surgery was applied to 33 (50%) patients and LPNST to 33 (50%) patients, RT was applied to 32 (48.5%) patients and not to 34 (51.5%) patients. In the EMG evaluation, latency was 2.1 ms (1.4–3.2) in the LPNST and 3.7 ms (1.9–12.4) in the control (p < 0.001) and amplitude values were 9650 mV (3120–36900) in the LPNST and 4780 mV (510–12.4) in the control (p < 0.001). The latency values in the Control receiving and not receiving RT were 4.0 ms (1.9–12.4) and 2.6 ms (1.9–6.2) respectively (p < 0.05). The latency values of the patients receiving and not receiving RT in the LPNST were 2.2 ms (1.8–3.2) and 2.0 ms (1.4–2.4) respectively (p < 0.05). In the Control and LPNST Group, no significant difference was determined between receiving and not receiving RT groups in respect of amplitude values (p > 0.05). Conclusion: The results of this study demonstrated that electromyographically the latency and amplitude values were better protected in the LPNST group. It was also seen that RT increased the formation of nerve damage in both groups. Keywords: Modified radical mastectomy, Radiotherapy, Electromyography, Lateral pectoral nerve, Pectoralis major muscle

Published
2019
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37. Cerebral Malaria: Case Report

Author

Serhat Tokgöz, Esra Eruyar, Ayşegül Öğmegül, and İbrahim Erayman

Subjects
Malaria, cerebral, epilepsy, Medicine, Neurology. Diseases of the nervous system, RC346-429
Abstract

Cerebral malaria is a rare complication caused by Plasmodium infection. Capillary blockage caused by infected erythrocytes, microglia activation and apoptosis of astrocytes as a result of cytokine leakage to the parenchyma are cited in the pathogenesis. Recently, a concept has evolved that metabolic changes in the brain in malaria infection may also be responsible for the epilepsy and encephalopathy pathogenesis. A 25-year-old male was admitted to our clinic for seizures and encephalopathy. The patient, diagnosed with cerebral malaria, recovered with antiedema, antiepileptic and antimalarial therapy. The pathophysiology and clinical and laboratory findings are discussed in light of the literature.

Published
2010

38. Postiktal psikoz

Author

Behiç Seren, Faruk Uğuz, Zehra Akpınar, and Serhat Tokgöz

Subjects
postiktal, epilepsi, psikoz, postictal, epilepsy, physichosis, Medicine (General), R5-920
Abstract

epileptik hastalarda görülen psikozların % 25’ini oluşturur. Tipik olarak tonik klonik veya kompleks parsiyel nöbet kümeleri sonrası ortaya çıkar. Bilateral bağımsız epileptik aktivite postiktal psikozlu hastalarda sıklıkla görülmektedir. Olguda postiktal psikoz gelişen ve risperidon ile tedavi edilen epileptik bir hasta sunulmuştur

Published
2012

39. Possible roles of sestrin2 in multiple sclerosis and its relationships with clinical outcomes

Author

Faruk Omer ODABAS, Ali Ulvi UCA, Turan AKDAG, Filiz DEMİRDÖGEN, Mustafa ALTAS, and Osman Serhat TOKGOZ

Subjects
Multiple Sclerosis, Sestrins, Apoptosis, Biomarkers, Inflammation, Oxidative Stress, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

ABSTRACT Background: Characterized by demyelination, inflammation and axonal damage, multiple sclerosis (MS) is one of the most common disorders of central nervous system led by the immune system. There is an urgent and obvious need for biomarkers for the diagnosis and follow-up of MS. Objective: To investigate serum levels of sestrin2 (SESN2), a protein that responds to acute stress, in MS patients. Methods: A total of 85 participants, 40 patients diagnosed previously with relapsing-remitting MS and 45 healthy controls, were included. Serum SESN2 parameters were investigated in blood samples drawn from each participant in the patient and control groups. Results: SESN2 levels were significantly lower in MS patients than in controls (z: -3.06; p=0.002). In the ROC analysis of SESN2, the predictive level for MS was 2.36 ng/mL [sensitivity, 72.50%; specificity, 55.56%; p=0.002; area under the curve (AUC)=0.693]. For the cut-off value in both groups, SESN2 was an independent predictor for MS [Exp (B)=3.977, 95% confidence interval (95%CI) 1.507-10.494 and p=0.013]. Conclusions: The decreased expression of SESN2 may play a role in MS pathogenesis, and SESN2 could be used as a biomarker for MS and as immunotherapeutic agent to treat MS.

Published
2022
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40. Clinical and radiologic features and their relationships with neurofunctional scores in patients with acute cerebellar infarct

Author

Hasan Huseyin Kozak, Ali Ulvi Uca, Necdet Poyraz, Suleyman Omer Anliacik, and Osman Serhat Tokgoz

Subjects
Cerebellar infarct, neurofunctional condition, radiological features, subcortical white matter lesion, Neurology. Diseases of the nervous system, RC346-429
Abstract

Background: Cerebellar infarct is a rare condition with very nonspecific clinical features. The aim of this study was to assess the full spectrum of the clinical characteristics, neuroimaging findings and neurofunctional analyses of cerebellar infarction, and the relationship between them. Materials and Methods: Data were collected from 59 patients admitted to our department during an 8-year period. We retrospectively analyzed the relationship between demographic characteristics, clinical symptomatology, etiological factors, functional condition, vascular distribution, frequency of subcortical white matter lesions (WMLs), and concomitant lesion outside the cerebellum in patients with acute cerebellar infarct (ACI) at time of admission. Results: The mean age in our series was 65.2 years, with most being male (57.6%). The posterior inferior cerebellar (PICA) artery was the most commonly affected territory at 62.7%. There was concomitant lesion outside the cerebellum in 45.7%. The main etiology in PICA was cardioembolism. While mean National Institutes of Health Stroke Scale on admission was 2.08 ± 1.67 in study group, modified Rankin Scale (mRS) on admission was detected to be mRS1 (n: 44, 74.5%) and mRS2 (n: 12, 20.3%) most frequently. Fourteen (35%) patients were detected to be in Fazekas stage 0; 11 (27.5%) patients in Fazekas stage 1; 6 (15%) patients in Fazekas stage 2; and 9 (22.5%) patients in Fazekas stage 3. Conclusion: Cerebellar infarct is very heterogeneous. The other cerebral area infarcts which accompany ACI negatively affect neurologic functional scores. Although it is difficult to detect the relationship between WMLs and neurologic functional severity, timely detection of risk factors and their modulation may be associated with prevention and treatability of WMLs, and this may be one of the important points for prevention of stroke-related disability.

Published
2016
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41. Acute-Phase Stroke Outcome and Lipids.

Author

Serhat Tokgoz O, Guney F, Kaya A, Bugrul A, Eruyar E, Buyukgol H, Seyithanoglu A, and Sinan Iyisoy M

Abstract

Objectives: The aim of the study is to investigate the relationship of lipid subgroups with short-term mortality in acute stroke (AS)., Methods: This retrospective study included 698 patients with AS who presented within 24 h of symptom onset. A hemogram from peripheral venous blood samples was taken at admission. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), TC/HDL-C rate, and TG/HDL-C rate were recorded. Duration of follow-up was defined as 30 days., Results: 64 out of 698 patients died during the follow-up period. The mean TG, TG/HDL-C, and TC/HDL-C levels were significantly lower in the mortality group than the survival group. In the receiver operating characteristic (ROC) analysis, the cutoff values and area under the curve of the TG, TG/HDL-C, TC, and TC/HDL-C levels for short-term stroke mortality are as follows ([100.2 mg/dL, 0.648]; [2.52, 0.650]; [170.50 mg/dL, 0.598]; and [4.32, 0.640], respectively). In the Cox regression model, only TG and TG/HDL-C, according to their ROC cutoff values, were independent variables as short-term mortality predictors (TG ≤100.2 mg/dL, HR:2.413 , 95% CI: 1.345-4.327, P:0.004); (TG/HDL ≤2.56, HR: 2.720, 95% CI: 1.389-5.359, P:0.003, respectively)., Conclusion: Dyslipidemia is a well-known as a risk factor of stroke. However, this study focused on the estimation that lower TG and TG/HDL-C levels at the time of hospital admission might be predictors of short-term mortality within a month of AS attack, which is a different subject from long term risk factors of stroke. Serum TG level may be a better indicator for mortality in the acute hypercatabolic trauma such as stroke., (Copyright © by The Medical Bulletin of Sisli Etfal Hospital.)

Published
2021
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