Mehmet Zarifoglu

SHOULDER FUNCTION AFTER ACCESSORY NERVE-SPARING NECK DISSECTIONS

This study was designed to observe the effect of preserving the spinal accessory nerve (SAN) during neck dissection (ND) and adjuvant radiotherapy (ART) after ND on shoulder function.

Comparison of Pre-Headache Phases and Trigger Factors of Migraine and Episodic Tension-Type Headache: Do they Share Similar Clinical Pathophysiology?

Trigger factors, signs and symptoms of the preheadache phases of episodic tension-type headache (ETTH), typical aura with non-migraine headache (TANMH), migraine with (MA) and without aura (MwA) may show similar features. Our objective was to investigate the preheadache phases and trigger factors of these headache types. Questionnaires including trigger factors, signs and symptoms of preheadache phases were answered by all headache patients. A total of 96 patients, 31 ETTH, nine TANMH, 23 MA and 33 MwA patients were included in this study. Analysis of seven groups consisting of 18 individual trigger factors showed that only two groups and five individual trigger factors were significantly different between groups. Hunger and odour were significantly more common in MA, MwA and TANMH patients. Foods were a significant precipitant factor for headache in MA patients. Head and neck movements were important trigger factors in ETTH. In prodrome phase only one out of three groups differed significantly between headache types. Migraine and TANMH patients reported significantly more general signs and symptoms. Analysis of aura signs and symptoms showed that only two out of six groups were significantly more frequent in MA and TANMH patients. Visual aura symptoms were more frequent in MA and TANMH groups, where sensorial auras were reported to be the most frequent in the MA group. Our results showed that different type of headaches share common prodrome and aura signs and symptoms as well as the same trigger factors. We suggest that similar trigger factors may trigger similar mechanisms and may cause common preheadache signs and symptoms in all headache types.

Headache prevalence in adolescents aged 12 to 17: a student-based epidemiological study in Bursa.

Background and Objectives.—The objective of this study was to investigate the prevalence and sociodemographic characteristics of headaches among Turkish adolescents aged 12 to 17 years old in Bursa province of Turkey.

Clinical characteristics of tension-type headache and migraine in adolescents : A student-based study

Background and objectives.—Adolescent headaches, particularly migraine, might present with different features from adult headaches. The objectives of this study were to investigate the characteristics of tension‐type headache and migraine, to find the sensitivity and specificity of the diagnostic criteria of the IHS classification according to age and gender.

Validity and Reliability of the Turkish Migraine Disability Assessment (MIDAS) Questionnaire

Objectives.—The aim of this study is to assess the comprehensibility, internal consistency, patient‐physician reliability, test‐retest reliability, and validity of Turkish version of Migraine Disability Assessment (MIDAS) questionnaire in patients with headache.

Risk of recurrence after first unprovoked tonic-clonic seizure in adults

The likelihood of seizure recurrence after a first unprovoked seizure has profound social, vocational and emotional implications for the patients. Recurrence rates have varied between 27% and 71% in various studies, and the management of patients with a single unprovoked seizure is a controversial topic. In this prospective study we investigated the influence of age, sex, family history, EEG patterns, and anticonvulsant drug (ACD) therapy on seizure recurrence after a first unprovoked tonic-clonic seizure in adults. For this purpose, between October 1988 and January 1991, we studied adult patients who had experienced their after unprovoked tonic-clonic seizure within last 2 months before neurological consultation, and followed them until June 1993. There were 147 patients who met the criteria for inclusion. Overall cumulative recurrence rates were 31.8% by 6 months, 41.3% by 1 year, 44.1% by 2 years, 42.2% by 3 years, and 45.2% by 4 years. Among the risk factors that were evaluated, the time of the day at which the initial seizure occurred was associated significantly (P < 0.05) with seizure recurrence. In our series, 62 patients received ACD and 85 did not. We did not find a significant difference in recurrence rate with regard to ACID therapy. Our results are comparable with those of studies reported preeviously and suggest that the majority of recurrences after a first unprovoked seizure were seen in the first year (in our series 89% of all recurrences). In our study there was no significant predictor of seizure recurrence, except the time of day at which the initial seizure occurred.

ACCESSORY NERVE FUNCTION AFTER LEVEL 2B-PRESERVING SELECTIVE NECK DISSECTION

The aim of this prospective study was to evaluate the relationship between accessory nerve functions and level 2b–preserving selective neck dissection.

Can ID MigraineTM be Used as a Screening Test for Adolescent Migraine

Although the ID MigraineTM has been developed and used for adults, it can also be used in adolescents. We aimed to investigate the validity of the ID MigraineTM in the adolescent student population. The study was performed on 1064 adolescents aged 12-17 years. A face-to-face semistructured interview was conducted with students after they had answered a 17-item questionnaire on sociodemographics and headache. Students who had had two or more headache attacks during the last 3 months then answered the ID MigraineTM. The sensitivity and specificity of the ID MigraineTM were 62.1± and 71.1±, respectively. The sensitivity was higher for patients with migraine with aura (71.1±), for girls (71.3±) and for younger adolescents (69.1±). The specificity was higher for boys (77.9±) and for older adolescents (73.3±). The K value was 0.316 (P< 0.001). Although the K value of the ID MigraineTM is low, the test may be a useful tool in screening adolescent migraine after some changes are made.

The distinct genetic pattern of ALS in Turkey and novel mutations

The frequency of amyotrophic lateral sclerosis (ALS) mutations has been extensively investigated in several populations; however, a systematic analysis in Turkish cases has not been reported so far. In this study, we screened 477 ALS patients for mutations, including 116 familial ALS patients from 82 families and 361 sporadic ALS (sALS) cases. Patients were genotyped for C9orf72 (18.3%), SOD1 (12.2%), FUS (5%), TARDBP (3.7%), and UBQLN2 (2.4%) gene mutations, which together account for approximately 40% of familial ALS in Turkey. No SOD1 mutations were detected in sALS patients; however, C9orf72 (3.1%) and UBQLN2 (0.6%) explained 3.7% of sALS in the population. Exome sequencing revealed mutations in OPTN, SPG11, DJ1, PLEKHG5, SYNE1, TRPM7, and SQSTM1 genes, many of them novel. The spectrum of mutations reflect both the distinct genetic background and the heterogeneous nature of the Turkish ALS population.

Protective Effect of Amifostine Against Toxicity of Paclitaxel and Carboplatin in Non-small Cell Lung Cancer

AbstractAim: In this study we determined the protective role of amifostine against the side effects of the combination of paclitaxel and carboplatin in patients with non-small cell lung cancer (NSCLC). Patients and Methods: Chemo-naive patients with NSCLC were eligible. Thirty-eight patients were randomized to receive paclitaxel 175 mg/m2 and carboplatin AUC=6 with amifostine 910 mg/m2 (group B) or chemotherapy alone (group A). The occurrences of hematologic, neurologic, cardiologic toxicities, and ototoxicity were evaluated. Results: All patients completed the six scheduled cycles of therapy. A total of 114 cycles of chemotherapy was given in both groups. Neutropenia grade 3–4 was observed in 11 cycles (9.6%) in group A and 19 cycles (16.6%) in group B (p=0.16). Paresthesia grade 1 or 2 was observed in 18 of 19 patients of group A and in 8 of 19 patients of group B, following the sixth cycle of chemotherapy (p=0.018). Two patients of group B and nine patients of group A suffered from sensory motor impairment grade 2 (p=0.029). There was no clinical evidence in any patient for deterioration in cardiac function. Asymptomatic and transient sinus bradycardia or ventricular premature beats developed in four patients. None of the patients reported vertigo, tinnitus, or hearing loss. Conclusion: The addition of the amifostine to the combination of paclitaxel and carboplatin may prevent or reduce the incidence of neurotoxicity in the treatment of NSCLC. Amifostine does not appear to have a preventive role in neutropenia.