Galip Ekuklu

Cognitive evaluation and functional outcome after stroke.

Özdemir F, Birtane M, Tabatabaei R, Ekuklu G, Kokino S: Cognitive evaluation and functional outcome after stroke. Am J Phys Med Rehabil 2001;80:410–415. ObjectiveTo investigate the initial overall cognitive ability and its components as a predictor of functional improvement and ambulation during rehabilitation. Initial cognitive status is widely known to be a predictive factor in functional recovery in patients with stroke although some reports have found no such relationship. DesignBaseline cognitive status was scored by Minimental State Examination and its subsections with such headings as “orientation,” “registration,” “attention and calculation,” “recall,” and “language” in 43 patients with postacute stroke, aged between 51 and 68 yr. Function was evaluated in terms of motor FIMTM and functional ambulation as categorized in “Adapted Patient Evaluation and Conference System” functional scale at the time of admission and discharge. ResultsOnly total baseline Minimental State Examination score showed a significant correlation with discharge motor FIM improvement (r = 0.31, P = 0.04) and baseline orientation score correlated significantly with functional ambulation score improvement (r = 0.31, P = 0.03). In stepwise linear regression model, the same variables had an effect on similar outcome parameters. ConclusionsCognitiveion evaluation should be taken as a whole to predict functional outcome in patients with postacute stroke, except for the baseline orientation score that seemed more predictive for ambulation.

The protective role of melatonin in experimental hypoxic brain damage.

Background : It is known that oxygen‐derived free radicals play an important role in the pathogenesis of brain injury. Melatonin is a powerful scavenger of the oxygen free radicals. In this study, the protective effect of melatonin against the damage inflicted by reactive oxygen species during brain hypoxia was investigated in newborn rats using biochemical parameters.

Migraine Prevalence and Some Related Factors in Turkey

Objectives.—The aim of our study is to determine the prevalence of migraine in Provincial Center of Edirne.

Clinical utility of dorsal sural nerve conduction studies in healthy and diabetic children

OBJECTIVE Monitoring of the dorsal sural sensory nerve action potential (SNAP) is a sensitive method for detection of peripheral neuropathies. We tried to determine the normal dorsal sural nerve conduction values of the childhood population and assessed the clinical utility of this method in diabetic children who have no clinical sign of peripheral neuropathy. METHODS In the study, 36 healthy and 27 diabetic children were included. In all subjects peripheral motor and sensory nerve studies were performed on the upper and lower limbs including dorsal sural nerve conduction studies. RESULTS The dorsal sural SNAP mean amplitude was 8.24+/-3.08 microV, mean latency was 2.47+/-0.48 ms, mean sensory conduction velocity was 41.63+/-5.43 m/s in healthy children. Dorsal sural SNAPs were absent bilaterally in one diabetic patient. In the other 26 diabetic patients, the mean dorsal sural nerve distal latency was longer (2.93+/-0.63 ms, P = 0.004), mean SCV was slower than in healthy subjects (36.68+/-7.66 m/s, P = 0.005). However, dorsal sural nerve amplitude was not different between the groups. A dorsal sural nerve latency of more than 2.9 ms had a sensitivity of 50% and a specificity of 75%. A dorsal sural nerve velocity of less than 36 m/s had a sensitivity of 54% and a specificity of 92%. CONCLUSIONS We designated the reference values of the dorsal sural nerve in healthy children. In addition, our findings suggest that dorsal sural nerve conduction studies may have value to determine neuropathy in the early stages in children with diabetes. SIGNIFICANCE The dorsal sural nerve conduction studies in diabetic children may have value to determine the neuropathy in its early stages.

Domestic Violence Against Married Women in Edirne

The aim of this study is to assess the prevalence and risk factors of domestic violence against married women in Edirne, Turkey. This is a cross-sectional study which included a representative sample of the married women living in the Provincial Center of Edirne. The total past year prevalence of some forms of physical domestic violence is 34% in the last 12 months. 93% of women reported that they have been experiencing different forms of verbal and psychological domestic violence. The important risk factors for physical domestic violence were being Roma woman (OR = 2.97, 95% CI: 1.44-6.12), living with more than four people in the household (OR = 2.29, 95% CI: 1.21-4.36), being unemployed (OR = 2.15, 95% CI: 1.06-4.37), and got married only with her families’ decision (OR = 4.60, 95% CI: 1.42-14.80). Our findings conclude that patriarchal and traditional values, women’s lack of financial autonomy, and low socioeconomic status are the risk factors for physical domestic violence.

Nucleated red blood cell counts and erythropoietin levels in high‐risk neonates

Background : The presence of increased numbers of nucleated red blood cells (NRBC) and increased levels of erythropoietin (EPO) in the circulation of neonates has been associated with states of relative hypoxia. The aim of this study is to assess the pattern of NRBC counts and EPO levels in a group of high‐risk neonates under stress conditions and determine the short‐term outcome for these babies by using these parameters.

Does quantitative tibial ultrasound predict low bone mineral density defined by dual energy X-ray absorptiometry?

Purpose Efforts for the early detection of bone loss and subsequent fracture risk by quantitative ultrasound (QUS), which is a non-invasive, radiation free, and cheaper method, seem rational to reduce the management costs. We aimed in this study to assess the probable correlation of speed of sound (SOS) values obtained by QUS with bone mineral density (BMD) as measured by the gold standard method, dual energy X-ray absorptiometry (DEXA), and to investigate the diagnostic value of QUS to define low BMD. Materials and Methods One hundred twenty-two postmenopausal women having prior standard DEXA measurements were included in the study. Spine and proximal femur (neck, trochanter and Wards triangle) BMD were assessed in a standard protocol by DEXA. The middle point of the right tibia was chosen for SOS measurement by tibial QUS. Results The SOS values were observed to be significantly higher in the normal BMD (t score > - 1) group at all measurement sites except for the lumbar region, when compared with the low BMD group (t score < - 1). SOS was negatively correlated with age (r = - 0.66) and month since menopause (r = - 0.57). The sensitivity, specificity, and positive and negative predictive values for QUS t score to diagnose low BMD did not seem to be satisfactory at either of the measurement sites. Conclusion Tibial SOS was correlated weakly with BMD values of femur and lumbar spine as measured by DEXA and its diagnostic value did not seem to be high for discriminating between normal and low BMD, at these sites.

Hypercoagulopathy in Stroke Patients with Nonvalvular Atrial Fibrillation: Hematologic and Cardiologic Investigations

The coagulation system is activated and coagulation activation markers are elevated in acute ischemic stroke with nonvalvular atrial fibrillation (NVAF). The etiology, severity, and prognosis of the ischemic stroke might be estimated with the level of the activation of the coagulation system. In this study, prothrombin F1+2 (F1+2), D-dimer, and fibrinogen levels were measured in patients with acute ischemic stroke with and without NVAF, and stroke severity was compared with these hemostatic parameters. Of 55 patients, 29 had sinus rhythm (group I), 26 had NVAF (group II); 20 healthy subjects (group III) were included in the study. Subtypes of cerebral infarction were classified. The patients underwent stroke severity, electrocardiography, echocardiography, cranial computed tomography, cervical duplex ultrasonography, and hemostatic parameter studies. In group II, F1+2 level (2.83±0.89) was significantly higher than in group I (2.33±0.80) and III (1.94±0.64) (p values: group I-II, 0.036; groups II-III, 0.001; groups I-III, 0.104). In group III, fibrinogen level (251.64±60.96) was significantly lower than that in groups I (347.97±111.49) and II (364.04±86.20) (p=0.001). D-dimer was not significantly different between groups. In group I, lacunar syndrome (LACS), and in group II, partial and total anterior circulation syndrome (PACS+TACS) were more common (p=0.013, p=0.001, respectively). In group II, Scandinavian Stroke Scale scores were lower than those in group I (group I=45.2±14, group II=35.4±18.9, p=0.02). In conclusion, activation of coagulation, demonstrated by increment F1+2, is more abundant in the stroke patients with NVAF than in the stroke patients with sinus rhythm. Our results also showed that activation of the hemostatic system might be related to stroke subtype and stroke severity. It is suggested that the oral anticoagulation treatment as prophylaxis is important in the prevention of stroke in patients with NVAF.

Body mass index percentiles among adolescent girls living in Edirne, Turkey

Background :  Body mass index (BMI) is the simplest way to measure obesity; therefore, it is chosen by many authorities as a screening method for adolescent obesity. Body mass index is positively correlated with the complications of childhood and adolescent obesity, such as hypercholesterolemia, insulin resistance, hypertension and long‐term development of cardiovascular diseases. The aim of the present study was to produce percentile curves for bodyweight, height and BMI in a representative sample of adolescent girls living in urban and rural areas of Edirne, Turkey, and to compare these percentile curves with curves from other countries.

Expression of the cyclin-dependent kinase inhibitor p27 in transitional cell bladder cancers: is it a good predictor for tumor behavior?

Objectives: Progression of the cell cycleis regulated by the interactions of cyclins,cyclin dependent kinases (CDKs) and CDKinhibitors (CDKIs). p27 is a member of theuniversal cyclin-dependent kinase inhibitorfamily. The level of p27 protein expressiondecreases during tumor development andprogression in some epithelial, lymphoid andendocrine tissues. It has been suggested thatp27 is an independent prognostic factor invarious human cancers. The prognostic value ofp27 protein expression is not completelyunderstood in bladder cancer yet.Aims: To investigate theimmunohistochemical expression of p27 intransitional cell bladder cancers and itsrelationship with clinicopathological data,proliferating cell nuclear antigen (PCNA) andp53 oncoprotein immunoreactivity.Methods: The expression of p27 proteinwas immunohistochemically analyzed inparaffin-embedded specimens of 75 patients withtransitional cell carcinoma of the bladder. p27expression was compared with tumor grade,stage, growth pattern, disease-free survival,progression, PCNA and p53 immunoreactivity.Results: Expression of p27 was notsignificantly related to clinicopathologicparameters, disease-free survival, progression,PCNA and p53 immunoreactivity.Conclusion: The results indicate that p27is not a good predictor for outcome oftransitional cell carcinoma of the bladder.