Yazar "Apak, Ismail" seçeneğine göre listele

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    Elevated plasma N-terminal pro-brain natriuretic peptide levels in acute ischemic stroke
    (Mosby-Elsevier, 2006) Iltumur, Kenan; Karabulut, Aziz; Apak, Ismail; Aluclu, Ufuk; Ariturk, Zuhal; Toprak, Nizamettin
    Background B-type natriuretic peptide (BNP) is a neurohormone secreted mainly in the cardiac ventricles in response to volume expansion and pressure overload. The aim of this study was to assess plasma N-terminal proBNP (NT-proBNP) changes in acute ischemic stroke (AIS). Methods The study group consisted of 57 (37 women aged 64 12 years) patients who had their first AIS and no history or signs of cardiovascular disease. An age-matched control group was also included (n = 57, 36 women aged 61 6 years). NT-proBNP, troponin I (TnI), and creatine kinase-MB were evaluated. A thorough cardiovascular and neurological investigation, including imaging techniques and lesion size determination, was also performed. Results The log NT-proBNP peak levels, TnI, and creatine kinase-MB levels were significantly higher in AIS compared with controls (7.25 +/- 1.77 vs 3.48 +/- 0.76 mu g/mL, P < .0001; 0.76 +/- 0.54 vs 0.5 +/- 0.0 ng/mL, P < .001; 57 +/- 37 vs 13 +/- 4 U/L, P < .001, respectively). The log NT-proBNP correlated positively with TnI (r = 0.29, P = .03) and heart rate (r = 0.41, P = .002), and negatively with left ventricular ejection fraction (r = -0.67, P < .0001). Patients with signs of marked myocardial ischemia and patients with insular cortex involvement had even higher NT-proBNP levels. After adjustment for relevant factors, the relation between the log NT-proBNP and AIS as well as insular cortex involvement was observed to be insignificant (P > .05 for both). Conclusions Our results show that NT-proBNP plasma levels are significantly elevated in AIS and might be of clinical importance as a supplementary tool for the assessment of cardiovascular function in patients with AIS.
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    Multiresistant bacterial colonization due to increased nurse workload in a neurology intensive care unit
    (Riyadh Armed Forces Hospital, 2006) Celen, Mustafa K.; Tamam, Yusuf; Hosoglu, Salih; Ayaz, Celal; Geyik, Mehmet F.; Apak, Ismail
    Objective: To determine the relationship between nurse workload and multiresistant bacteria colonization or infection (MRB+) in a neurology intensive care unit (ICU). Methods: We studied the relationship between nurse workload and MRB+ development in patients who were hospitalized in Dicle University Neurology Department ICU, Turkey during a 6-month period from November 15, 2003 to April 15, 2004. The intensity of workload and procedures applied to the patients were scored with the Project de Recherche en Nursing (PRN) and the Omega scores. Results: Of 138 patients followed, 71 (51.4%) were female and 67 (48.6%) were male. The mean age of females was 65.6 +/- 6.7 years, and of males was 62.2 +/- 15.8 years. The mean time of hospitalization in the ICU was 13 +/- 7.6 days. In 26 (18.8%) cultures taken from patients, multiresistant bacteria (MRB) were demonstrated. The development of MRB+ infection was correlated with length of stay (LOS), Omega 2, Omega 3, Total Omega, daily PRN, and total PRN (p<0.05). There was no correlation between development of MRB+ infection with gender, age, APACHE-II and Omega 1 scores (p>0.05). In the PRN system, when the workload of nurses was compared, it was seen that in the MRB colonized patient group, the workload of nurses was meaningfully higher than the MRB patient (-) group (p<0.001). Conclusion: As a result, the risk of MRB+ development in the ICU is directly proportional to understaffing, increased nurse workload, LOS, and procedures applied to patients. In management of nosocomial infection, it is crucial to increase the number of nurses in the ICU, and thus, decrease the workload.
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    The Role of Central Nervous System in the Pathogenesis of Restless Legs Syndrome
    (Yerkure Tanitim & Yayincilik Hizmetleri A S, 2006) Acar, Suat; Apak, Ismail; Tamam, Yusuf; Gencer, Ahmet Murat
    Restless legs syndrome is a neurological disorder of the legs characterized by spontaneous movements and paresthesia which appear at rest or sleep and are relieved movements. The studies searching for the ethiopathogenesis of the syndrome showed the role of the central nervous system. According to electrophysiological and neuroimaging studies, abnormalities involving corticothalamospinal tracts which contribute locomotor system physiology have been determined. Recent studies showed dysfunction of the central dopaminergic systeni and symptoms could be ameliorated by dopaminergic drugs. Although central circadian factors of the disorder were suspected to be responsible for ethiopathogenesis, most factors remain to be elucidated. Uncertain aspects of the disorder may be explained more definitely after the researches focus on sensory-motor symptoms organized in central structures, participating neuron types, mediating neurotransmitters and central control mechanisms.