Papers by Selen Gür özmen
Seizure-european Journal of Epilepsy, Mar 1, 2013
Seizure-european Journal of Epilepsy, Feb 1, 2017
Up to 60% of people with epilepsy (PwE) have psychiatric comorbidity including anxiety. Anxiety r... more Up to 60% of people with epilepsy (PwE) have psychiatric comorbidity including anxiety. Anxiety remains under recognized in PwE. This study investigates if screening tools validated for depression could be used to detect anxiety disorders in PWE. Additionally it analyses the effect of anxiety on QoL. METHODS 261 participants with a confirmed diagnosis of epilepsy were included. Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and Emotional Thermometers (ET), both validated to screen for depression were used. Hospital Anxiety and Depression Scale-Anxiety (HADS-A) with a cut off for moderate and severe anxiety was used as the reference standard. QoL was measured with EQ5-D. Sensitivity, specificity, positive and negative predictive value and ROC analysis as well as multivariate regression analysis were performed. RESULTS Patients with depression (n=46) were excluded as multivariate regression analysis showed that depression was the only significant determinant of having anxiety in the group. Against HADS-A, NDDI-E and ET-7 showed highest level of accuracy in recognizing anxiety with ET7 being the most effective tool. QoL was significantly reduced in PwE and anxiety. CONCLUSIONS Our study showed that reliable screening for moderate to severe anxiety in PwE without comorbid depression is feasible with screening tools for depression. The cut off values for anxiety are different from those for depression in ET7 but very similar in NDDI-E. ET7 can be applied to screen simultaneously for depression and "pure" anxiety. Anxiety reduces significantly QoL. We recommend screening as an initial first step to rule out patients who are unlikely to have anxiety.
Journal of Headache and Pain, Sep 18, 2014
18.04.2014 tarihine kadar kullanımı yazar tarafından kısıtlanmıştır.İstanbul Bilim Üniversitesi, ... more 18.04.2014 tarihine kadar kullanımı yazar tarafından kısıtlanmıştır.İstanbul Bilim Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim DalıAcil servise başvuran akut inme hastalarının yaklaşık %20-50’sinde hiperglisemi saptanmaktadır (1,2) ve bu hastaların çoğunda bilinen diyabetes mellitus (DM) hikâyesi yoktur (3). Acile girişte potansiyel kurtarılacak penumbral beyin dokusu olan hastalarda kan şekeri daha yüksek olabilir. Bu hastalara uygulanan insülin tedavisinin güvenli olup olmadığı tartışmalıdır. Benzer olarak acil servise başvuran %75 (4) ila %81 (5) akut inme hastasının kan basıncı yüksek saptanmaktadır ve yaklaşık %50’sinde hipertansiyon (HT) hikâyesi yoktur (5). Akut inmede saptanan yüksek kan basıncının nedeni tam olarak bilinmemektedir. Acile girişte potansiyel kurtarılacak penumbral beyin dokusu olan hastalarda daha yüksek kan basınçları ortaya çıkıyor olabilir. Bu nedenle de bu hastalara uygulanacak anti-hipertansif tedavi stratejisi belirsizdir. Bu çalışmada inmenin hipera...
BMC Pregnancy and Childbirth
Objective To evaluate the effectiveness of immersive virtual reality (VR) on patient satisfaction... more Objective To evaluate the effectiveness of immersive virtual reality (VR) on patient satisfaction as a distractive tool and pain relief among laboring women. Methods This was a randomized, controlled clinical trial with 42 laboring women allocated to VR intervention and control groups. Among women in the VR group, patient satisfaction with the use of VR was assessed by a Virtual Reality Satisfaction Survey, measured by a Visual Analog Scale (VAS) score and evaluated by questioning them about whether they would choose VR in future labor. As a primary outcome, patient satisfaction scores regarding the overall childbirth experience were compared between women in the two groups. A secondary outcome was pain assessed by a visual pain rating scale in the early and active phases of labor in women in both groups. Psychometric information was also collected from participants in each group using the Beck Anxiety Inventory and Beck Depression Inventory. Results We observed a high level of pati...
Türk Nöroloji Dergisi, 2013
Cerebral amyloid angiopathy (CAA) is caused by deposition of beta-amyloid protein on the walls of... more Cerebral amyloid angiopathy (CAA) is caused by deposition of beta-amyloid protein on the walls of cortical, subcortical and leptomeningeal arteries and it is one of the causes of lobar intracerebral hemorrhage. The beta-amyloid protein deposits can be found in the cerebellum as well as the cerebrum. Cerebellar hematomas do not exclude the diagnosis of CAA. Definitive diagnosis of CAA is established by pathological examination at autopsy, however its diagnosis may be suggested by subarachnoid or superficial cortical hemosiderosis in blood sensitive MRI sequences. This case with an intense cerebellar hemosiderosis typical for superficial siderosis (SS) of the central nervous system is reported as a rare example of CAA as the underlying cause
Objective: To evaluate the effectiveness of immersive Virtual Reality (VR) in laboring women on p... more Objective: To evaluate the effectiveness of immersive Virtual Reality (VR) in laboring women on patient satisfaction as a distractive tool and pain relief.Methods: Randomized, controlled clinical trial with 42 laboring women allocated to VR intervention and control groups. Among the VR group, patient satisfaction with the use of VR was assessed by a Virtual Reality Satisfaction Survey and questioning whether they would choose VR in future labor. As a primary outcome patient satisfaction scores regarding the overall labor and delivery experience were compared between the two groups. A secondary outcome was pain assessed by a visual pain rating scale in the early and active phases of labor in both groups. Psychometric information was also collected from participants in each group using Beck Anxiety Inventory and Beck Depression Inventory. Results: We observed a high level of patient satisfaction with the use of immersive VR during labor. The survey revealed a mean satisfaction score o...
Cumhuriyet Medical Journal, 2019
Which risk factors are important in preventing or stabilizing possible extra-cranial carotid arte... more Which risk factors are important in preventing or stabilizing possible extra-cranial carotid artery stenosis is unclear. We aimed to investigate risk factors that are associated with extra-cranial carotid artery stenosis in patients with ischemic stroke. Method: The records of 215 patients with ischemic stroke who were admitted to Taksim Research Hospital were screened. Patients who had been monitored with color Doppler ultrasonography were then categorized on the basis of the degree of stenosis in the carotid artery (group A: 0%-49%, group B: 50%-69%, group C: >70%). Hypertension, diabetes mellitus hyperlipidemia, cigarette smoking, ischemic heart disease, age, and sex were evaluated as risk factors. These risk factors were compared among the three groups by using SPSS version 17. Results: We found a significant relationship between high mean low-density lipoprotein and the severity of carotid stenosis (p<0.05). A simila relationship was found between sex and the severity of carotid stenosi (p<0.05). Conclusions: A high low-density lipoprotein level and male sex are important risk factors for having extra-cranial carotid artery stenosis Therefore, use of more aggressive lipid-lowering treatments, recommending an appropriate diet, and encouraging physical activity in hyperlipidemic men are important in preventive medical practice.
Medicine, 2019
Patients with severe stroke and salvageable brain tissue at admission, who have higher glycaemic ... more Patients with severe stroke and salvageable brain tissue at admission, who have higher glycaemic and blood pressure levels, may have a risk of iatrogenic hypoglycemia/iatrogenic hypotension. In this study, we examined the relationship between the presence of diffusion-weighted imaging (DWI)/perfusion-weighted imaging (PWI) mismatch, admission blood glucose level, and admission blood pressure level in patients who were admitted in the first 12 hours after onset. We studied 212 patients who were prospectively and consecutively registered to the stroke unit from 2006 to 2009. Correlations between mismatch and admission blood pressure level (ABPL) and admission blood glucose level (ABGL) were analyzed using multivariate logistic regression. Mismatch (P = .064, adjusted OR = 2.297, 95% CI, 0.953-5.536) was not associated with a high ABGL in the whole group. However, after excluding patients with diabetes mellitus (DM) (n = 67, 35%), mismatch (P = .033, adjusted OR = 3.801, 95% CI, 1.110-13.015), an impaired level of consciousness, use of anti-DM medication, glycated hemoglobin levels, and cardioembolic aetiology were independent predictors of a high ABGL. The presence of mismatch or proximal vessel occlusion was not associated with ABPL. Female sex (P = .048) and total anterior circulation stroke (P = .008) were independent predictors associated with a higher ABPL. We conclude that patients with hyperacute ischemic stroke with PWI/DWI mismatch are more likely to have hyperglycemia. Abbreviations: AF = atrial fibrillation, DM = diabetes mellitus, DWI = diffusion-weighted imaging, Hba1c = glycated hemoglobin, LACS = lacunar stroke, MR = magnetic resonance, NIHSS score = National Institutes of Health Stroke Scale, PACS = partial anterior circulation stroke, POCS = posterior circulation stroke, PWI = perfusion-weighted imaging, TACS = total anterior circulation stroke.
SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, 2018
M igraine headache is a complicated, repetitive headache disorder that is a very pervasive compla... more M igraine headache is a complicated, repetitive headache disorder that is a very pervasive complaint in neurology. The overall prevalence is 5% to 15%, [1, 2] and it is more frequent among females than males. [3] Migraines are thought to be related to various comorbid disorders, such as epilepsy, depression, anxiety, ischemic stroke, Raynaud's phenomenon, iron deficiency anemia, obesity, insulin resistance (IR), and metabolic syndrome. [4-6] However, the relationship between migraines and these comorbid disorders is not yet clear, [7] particularly any association with obesity, IR, or metabolic syndrome. Some researchers have found an association between metabolic syndrome and migraine; [4, 8] however other studies have had different results. [9] Guldiken et al. [4] found that Objectives: The aim of this study was to examine the relationship between migraines and obesity, insulin resistance (IR), and metabolic syndrome in female migraineurs. Methods: A total of 141 female patients who experience migraines and a control group of 141 sex-and age-matched individuals who do not were enrolled in this case-control study. The migraine group was composed of patients from the Gebze Fatih Community Hospital (Kocaeli, Turkey) neurology outpatient service and the control group included hospital staff and friends who volunteered to participate. Descriptive statistics and multivariate logistic regression analyses were performed. Migraine was designated as a dependent variable. Family history of migraine, stroke, metabolic syndrome, cardiac disease, hypertension, hyperlipidemia, and diabetes mellitus; cigarette use; alcohol consumption; and the presence of hypertension, IR, hypertriglyceridemia, low level of high-density lipoprotein (HDL), central obesity, metabolic syndrome; as well as homeostasis model assessment and quantitative insulin sensitivity check index results were selected as independent variables. Results: The mean waist circumference, mean height, mean weight, and central obesity were greater in the control group (p=0.009, 0.004, 0.036, and 0.015, respectively). A multivariate logistic regression model of migraine presence showed that a family history of migraine (odds ratio [OR]: 1.542, 95% confidence interval [CI]: 2.451-8.905; p<0.0001), family history of stroke (OR: 1.043, 95% CI: 1.214-6.633; p=0.016), and no central obesity (OR:-0.705, 95% CI:-0.290-0.843; p=0.010) were statistically significant variables in our study. Conclusion: The results of our study indicated that IR and metabolic syndrome were not associated with migraine in women. There was an inverse relationship between central obesity and migraine. Additional research with larger participant groups should be performed to further explore the complex relationship between migraine, obesity, IR, and metabolic syndrome.
European Journal of Neurology, 2017
Background and purposePeople with epilepsy are at increased risk of accidents and injuries but, d... more Background and purposePeople with epilepsy are at increased risk of accidents and injuries but, despite several studies on this subject, data regarding preventable causes are still contradictory. The aim of this study was to investigate the relationship between injuries, side effects of antiepileptic drugs (AEDs) and depression.MethodsData from a consecutive sample of adult patients with epilepsy attending the outpatient clinics at St George's University Hospital in London were included. All patients were asked if they had had any injury since the last clinic appointment and completed the Liverpool Adverse Event Profile (LAEP) and Neurological Disorders Depression Inventory for Epilepsy.ResultsAmong 407 patients (243 females, mean age 43.1 years), 71 (17.4%) reported injuries since the last appointment. A two‐step cluster analysis revealed two clusters with the major cluster (53.5% of the injured group) showing a total score for LAEP ≥45, a positive Neurological Disorders Depres...
Pain Medicine, 2015
Objective. Association between iron deficiency anemia (IDA) and migraine, its subgroups, or tensi... more Objective. Association between iron deficiency anemia (IDA) and migraine, its subgroups, or tension-type headache (TTH) has not yet been shown. This study aimed to determine whether there was an association between IDA and these disorders. Design. Case-control study.
Noro Psikiyatri Arsivi, 2015
Behçet' s disease (BD) was described as a three-symptom complex comprising uveitis, oral aphthae,... more Behçet' s disease (BD) was described as a three-symptom complex comprising uveitis, oral aphthae, and genital ulcerations. It is a multisystemic, recurrent, inflammatory disorder and it is of unknown cause. Neuro-Behçet (NB) is present in 5%-7% of BD. Movement disorders have rarely been reported in NB. Here, we report a case of chronic parenchymal NB presenting with chorea.
Noro Psikiyatri Arsivi, 2015
Nöro Psikiyatri Arşivi, 2014
Nöro Psikiyatri Arşivi, 2014
Sporadic Creutzfeldt-Jacob disease (sCJD) usually presents with typical clinical signs. Prodromal... more Sporadic Creutzfeldt-Jacob disease (sCJD) usually presents with typical clinical signs. Prodromal symptoms lasting for several weeks are followed by dementia, myoclonus, ataxia and abnormalities of vision (1). Supranuclear gaze palsies accompanying sCJD have rarely been reported. Some of these reported cases were initially diagnosed as progressive supranuclear palsy (PSP) and the diagnosis was corrected only after pathological examination had revealed spongioform encephalopathy (2,3). We aimed to report a patient who presented with supranuclear ophtalmoparesis, rapidly progressive gait ataxia and dementia as his initial manifestations of probable sCJD. A 46-year-old man had presented with a 2 monthhistory of rapidly progressive gait instability, slurred speech and cognitive deterioration. He also reported diplopia and insomnia. The patient was alert but disoriented and his mini mental status examination score was 21. Voluntary vertical eye movements were almost abolished, but could be elicited by doll's eyes maneuver. In horizontal gaze examination, his smooth pursuit was replaced by microsaccades and his eyes were unable to perform convergence. He had a severe cerebellar dysarthria, impaired rapid alternating movements and severe bilateral dysmetria of upper and lower extremities. He also had a moderate gait ataxia. Neurological examination was otherwise normal. His routine blood chemistry was normal. Cerebrospinal fluid analysis was normal for cell counts, protein and glucose levels, oligoclonal bands, infectious agent and paraneoplastic antibody scanning. However CSF 14-3-3 protein was positive and CSF total tau level was highly increased (1646 pg/ml). Brain MRI revealed bilateral FLAIR and T1 hyperintensities of caudate nuclei, putamina and frontal lobe involving most of the anterior cingulate gyrus and superior frontal gyrus bilaterally, with restricted diffusion (Figure 1). EEG showed decreased amplitudes but no typical periodic sharp waves. He was diagnosed as
We aimed to determine the characteristics affecting insulin resistance in non-obese middle-aged a... more We aimed to determine the characteristics affecting insulin resistance in non-obese middle-aged adults in a rural community. METHODS: A total of 1,270 non-diabetic adults aged between 40 and 64 years old with body mass index (BMI) less than 25 kg/m 2 were analyzed. Subjects with insulin resistance were defined as those who had the highest quartile value of the homeostasis model assessment of insulin resistance (HOMA-IR) in a non-diabetic population. RESULTS: A total of 217 subjects (20.6%) had insulin resistance. Prevalence of metabolic syndrome was significantly higher in insulin-resistant subjects in both men (29.3% vs. 10.3%) and women (34.1% vs. 15.6%). Among metabolic syndrome components, elevated waist circumference and elevated triglyceride were higher in insulin-resistant subjects in both genders. After being controlled for socioeconomic status and lifestyle related covariates, the association between insulin resistance and BMI was statistically significant in the category of 23.0-24.9 kg/m 2 in men (adjusted OR, 4.63; 95% confidence interval [95%CI], 1.77-12.15) using the category of 18.5-20.9 kg/m 2 as a reference. In addition, the association between insulin resistance and abdominal obesity was statistically significant only for men (adjusted OR, 2.57; 95%CI, 1.29-5.11). CONCLUSION: Insulin resistance appears to be highly associated with high BMI and abdominal obesity, even in non-obese, non-diabetic middle-aged men.
Nöro Psikiyatri Arşivi, 2014
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Papers by Selen Gür özmen