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Acil serviste olanzapin zehirlenmelerinin klinik özellikleri: Üç yıllık tecrübemiz
(2010) Güloğlu, Cahfer; Doğan, Halil; Altuncı, Yusuf Ali; Tamam, Yusuf; Orak, Murat; Üstündağ, Mehmet
Amaç: Dünyada yaygın olarak kullanılmaya başlanmasından beri olanzapin zehirlenmesinin klinik özellikleri acil servis için önemli olmaya başlamıştır. Çalışmamızda olanzapin zehirlenmesi olan hastaları geriye dönük olarak araştırmayı amaçladık. Yöntem: Şubat 2004-Nisan 2007 tarihleri arasında acil servisimize olanzapin zehirlenmesi nedeniyle başvuran hastaların kayıtları arşivimizden geriye dönük olarak tarandı. Zehirlenmenin ciddiyetini belirle-mede Avrupa PSS skoru (The Poisoning Severity Score of the European Association of Poison Centers and Clini-cal Toxicologists: EAPCCT) kullanıldı. Bulgular: Çalışmamız olanzapin zehirlenmesi olan 15 hastayı içermekte-dir. Kadın/erkek oranı ikidir. Ortalama yaş 27.33±9.27 yıl (aralık: 17-48) ve hastaneye başvuru ile zehirlenme arasında geçen süre ortalama 3.96±2.38 saat (aralık: 1.5-10) idi. Alınan olanzapin miktarı 50-600 mg arasında değişmekteydi. Tek başına olanzapin alan dokuz hastanın dördünde (%44.4) PSS puanı düşük, dördünde (%44.4) orta ve birinde (11.2) yüksek bulundu. PSS puanı düşük olan grupta ortalama alınan olanzapin dozu 50-75 mg arasında değişirken, PSS puanı orta olan grupta alınan en düşük doz 140 mg idi. Sonuçta 13 hasta şifa ile taburcu edildi ve iki hasta öldü. Sonuç: Çalışmamızdaki bulgular göstermiştir ki, akut olanzapin zehirlenmesi görece iyi tolere edilmesine karşın, özellikle diğer ilaçlarla birlikte ve yüksek doz alımlarında yaşamı tehdit edebil-mektedir. Doz ile klinik özellikler ve prognoz arasında ilişki vardır.
Adipokines in Multiple Sclerosis Patients with and without Optic Neuritis as the First Clinical Presentation
(Taylor & Francis Inc, 2019) Duzel, Berna; Tamam, Yusuf; Coban, Arzu; Tuzun, Erdem
Background: Adipocytokines have been implied to be involved in multiple sclerosis (MS) pathogenesis. MS patients whose first clinical episode is optic neuritis (ON) have been reported to display a milder disease course. In this study, we aimed to show whether this milder disease course is related to reduced adipokine production. Methods: A total of 55 (24 with ON as the first clinical episode) relapsing-remitting MS (RRMS) patients and 40 healthy individuals were recruited. Concentrations of adipokines were measured in sera by ELISA. Results: The levels of adiponectin, leptin, resistin, monocyte chemoattractant protein-1 (MCP-1) and IL-8 were significantly higher in RRMS patients compared with healthy controls. RRMS cases starting with ON had lower expanded disability status scale scores. Serum adiponectin, leptin, resistin and MCP-1 levels were significantly lower in MS patients, whose first clinical episode was ON. Conclusions: MS patients with ON as the first manifestation display both lower disability scores and reduced serum adipokine levels implying that adipocytokine production is associated with MS progression. Exact mechanisms of this association in MS patients with first episode ON need to be further studied.
Akut iskemik strokta beyin tomografisi erken bulgularının değerlendirilmesi
(Dicle Üniversitesi Tıp Fakültesi, 2008) Taşdemir, Nebahat; Tamam, Yusuf; Tabak, Veysi; Dedeoğlu, Andaç
Son 30 yılda gelişen görüntüleme yöntemleri akut iskemik strokta sadece tanı sürecini değil, uygulanacak tıbbi ve girişimsel müdahaleleri de yönlendirmektedir. Strok sonrası ilk 24 saatte beyin tomografisi (BT) halen daha hızlı, daha ucuz, non invaziv ve tüm hastalar için kolay ulaşılabilir olması nedeniyle primer tarama yöntemi olmayı sürdürmektedir. Bu çalışmada Nöroloji kliniğine başvuran iskemik strok olgularının erken evre BT bulgularının saptanması ve bu bulgular ile çeşitli klinik ve demografik veriler arasındaki ilişkinin araştırılması amaçlanmıştır. Bu çalışmaya iskemik strok tanısı almış 26' sı erkek, 38' i kadın toplam 64 olgu dahil edilmiştir. Olguların strok sonrası ilk 8-12 saatte ve 24-48. saatler arasında olmak üzere toplam iki BT incelemesi yapılmıştır. Çalışma sonucunda erken BT bulgusu veren olgularda, orta serebral arter alan tutulumunun daha çok görüldüğü saptanmıştır. Erken BT bulguları arasında görülen orta serebral arter hiperdansitesinin arteriyel oklüzyona uyan iskeminin bir habercisi olabileceği düşünülmüştür. Başlangıçta saptanan anormal BT bulgularının, ilerlemekte olan infarktın büyüklüğünü olduğundan daha az gösterdiği belirlenmiştir. Ayrıca erken BT bulgularının acil şartlarda değerlendirilmesi ile ayrıntılı değerlendirilmesi arasında belirgin bir farklılık mevcuttur. İskeminin erken BT bulguları, iskemik strokun ilk saatlerinde bile görülebilir. Erken BT bulgularının tanımlanması düzenli eğitim ve gelişen BT teknolojisi izlenerek geliştirilmelidir.
Apolipoprotein E Genotype in Patients with Cerebrovascular Diseases and its Effect on the Disease Outcome
(Taylor & Francis Ltd, 2009) Tamam, Yusuf; Tasdemir, Nebahat; Toprak, Recep; Tamam, Banu; Iltumur, Kenan
A total of 100 hospitalized stroke patients and 30 healthy controls were included in a study aiming to determine the predictive role of ApoE genotype polymorphism for stroke outcome in the Turkish population. The most frequent ApoE genotype was 3/3 reflecting Asian population polymorphic distribution. ApoE polymorphism in the Eastern Turkish population was found to be independent of stroke type, OSCP subtypes of infarction, localization of hemorrhage, severity of carotid artery stenosis, and resultant stroke outcome. Distinct polymorphic results in populations from nearby regions suggest a multifactorial pathogenesis and presence of very complex genetic factors in the development of stroke and stroke outcome.
Assessment of Myocardial Function by Myocardial Performance Index in Patients with Acute Ischemic Stroke
(2019) Tamam, Yusuf; Öztürk, Önder; Öztürk, Ünal
Objective: Acute stroke is an important cause of morbidity and mortality. Myocardial injury is an importantcomplication of acute cerebrovascular events. In this study, we aimed to investigate the relationship betweenmyocardial function assessed by myocardial performance index (MPI) and National Institutes of Health Stroke Scale(NIHSS) score in patients with acute ischemic stroke.Method: The study comprised 97 patients (males, 42; females, 55; 65 ± 16 years) diagnosed with acute ischemicstroke. 17 patients were excluded. Patients were divided into two groups based on the calculated NIHSS score (Group1, NIHSS score < 16; Group 2, NIHSS score ? 16). Demographic, clinical, and laboratory data for all patients werecollected. Cardiac function was evaluated by transthorasic echocardiography within 48 hours of admission to theneurology care unit.Results: There were no significant differences among demographic parameters of patients. MPI was significantlyhigher in Group 2 patients than in Group 1 patients (0.59±0.25 vs 0.48±0.20, p=0.004).Conclusion: Our results suggest that MPI is associated with stroke severity on admission in patients with acuteischemic stroke. MPI is an indicator of global myocardial dysfunction with a different from LVEF. MPI, which includesboth systolic and diastolic time intervals is an option to assess the global cardiac dysfunction.
Assessment of myocardial function by myocardial performance index in patients with acute ischemic stroke
(Dicle Üniversitesi Tıp Fakültesi, 2019) Öztürk, Ünal; Öztürk, Önder; Tamam, Yusuf
Objective: Acute stroke is an important cause of morbidity and mortality. Myocardial injury is an important complication of acute cerebrovascular events. In this study, we aimed to investigate the relationship between myocardial function assessed by myocardial performance index (MPI) and National Institutes of Health Stroke Scale (NIHSS) score in patients with acute ischemic stroke. Method: The study comprised 97 patients (males, 42; females, 55; 65 ± 16 years) diagnosed with acute ischemic stroke. 17 patients were excluded. Patients were divided into two groups based on the calculated NIHSS score (Group 1, NIHSS score < 16; Group 2, NIHSS score ≥ 16). Demographic, clinical, and laboratory data for all patients were collected. Cardiac function was evaluated by transthorasic echocardiography within 48 hours of admission to the neurology care unit. Results: There were no significant differences among demographic parameters of patients. MPI was significantly higher in Group 2 patients than in Group 1 patients (0.59±0.25 vs 0.48±0.20, p=0.004). Conclusion: Our results suggest that MPI is associated with stroke severity on admission in patients with acute ischemic stroke. MPI is an indicator of global myocardial dysfunction with a different from LVEF. MPI, which includes both systolic and diastolic time intervals is an option to assess the global cardiac dysfunction.
Assessment of myocardial function by tissue Doppler imaging myocardial performance index in patients with acute ischemic stroke
(Çukurova Üniversitesi Tıp Fakültesi, 2019) Öztürk, Ünal; Öztürk, Önder; Tamam, Yusuf
Purpose: The aim of this study is to investigate the relationship between myocardial function assessed by tissue Doppler imaging myocardial performance index (TDI-MPI) and National Institutes of Health Stroke Scale (NIHSS) score in patients with acute ischemic stroke. Materials and Methods: The study comprised 128 patients (males, 55; females, 73; 68 ± 19 years) with acute ischemic stroke. 20 patients were excluded. Patients were divided into two groups based on the calculated NIHSS score (Group 1, NIHSS score < 16; Group 2, NIHSS score ≥ 16). Demographic, clinical, and laboratory data for all patients were collected. Cardiac function was evaluated by transthorasic echocardiography within 48 hours of admission to the neurology care unit. Results: There were no significant differences among demographic parameters of patients. Tissue Doppler myocardial performance index was significantly higher in Group 2 patients than in Group 1 patients (0.62±0.28 vs 0.46±0.16). Conclusion: Our results suggest that TDI-MPI is associated with stroke severity on admission in patients with acute ischemic stroke. TDI-MPI is an indicator of global myocardial dysfunction with a different from LVEF. TDI-MPI, which includes both systolic and diastolic time intervals to assess the global cardiac dysfunction
The Association Between Apolipoprotein E Genetic Polymorphisms and Multiple Sclerosis
(Aves, 2013) Tasdemir, Nebahat; Tamam, Yusuf; Yalman, Mediha
Background: Although the etiology of multiple sclerosis (MS) has not yet been clearly elucidated, MS is a chronic inflammatory disease, in which genetic and environmental factors are involved. The association between apolipoprotein E (APOE) genetic polymorphisms and various neurodegenerative diseases, including MS, is controversial. In the current study, specific APOE genotypes were investigated in patients with MS. Methods: Fifty patients clinically diagnosed with MS and 30 healthy volunteers were included in the study. The APOE genotype was identified via the polymerase chain reaction (PCR) method. The patient and control groups were compared in terms of the frequency of APOE genotypes. Results: The APOE genotype distribution in the patient group was as follows: epsilon 3/epsilon 3, 82.0%; epsilon 3/epsilon 4, 12.0%; and epsilon 2/epsilon 3, 6.0%. There were no significant differences between the patient and control groups with respect to the frequency of APOE genotypes, and APOE epsilon 4 allele carriage (p=0.56). However, the frequency of APOE epsilon 4 allele carriers were significantly higher among male patients (p=0.007). Conclusion: These findings suggest that the APOE genotype has no effect on susceptibility to MS. Further studies with larger sample sizes to be able to include all APOE genotypes are warranted. Identification of genetic factors that may have a role in the etiology of MS will make a substantial contribution to the knowledge of the prevention and treatment of MS.
Association of apolipoprotein e genotype and cerebrovascular disease risk factors in a Turkish population
(Taylor & Francis Ltd, 2008) Tasdemir, Nebahat; Tamam, Yusuf; Toprak, Recep; Tamam, Banu; Tasdemir, M. Serhan
The purpose of the present study was to investigate the predictive role of apolipoprotein E genotypes for stroke-related risk factors in the Turkish population. Among 100 stroke patients and 30 healthy subjects included in the study, most frequent Apo E genotype was epsilon 3/3, compatible with polymorphic distribution of Asian population. VLDL and triglyceride levels in epsilon 2/4(+) subjects were higher than in epsilon 2/4(-) patients. HDL and homocysteine levels were higher in epsilon 4/4 (+) subjects than in epsilon 4/4 (-) stroke patients. These results suggest that ApoE polymorphism in this population was not associated with any other demographic or clinical variables except for lipid profiles and homocysteine levels.
Behçet hastalığına bağlı psödotümör serebride kraniyal manyetik rezonans görüntülemesinde optik sinir kılıfında sıvı artışı
(2011) Tamam, Yusuf; Uzar, Ertuğrul; Ekici, Faysal; Şahin, Alparslan; Açar, Abdullah; Taşdemir, Nebahat
Psödotümör serebri Behçet hastalığında ender görülen bir durumdur. Optik sinir kılıfında genişleme ve optik sinir etrafında subaraknoid aralıkta sıvı artışı, psödotümör serebrili hastalarda nadir gözlenen manyetik rezonans (MR) bulgularıdır. Bildiğimiz kadarıyla Behçet hastalığına bağlı psödotümör serebride bu bulgular literatürde bildirilmemiştir. Bu tür olgularda lumboperitoneal şant cerrahisi medikal tedaviye yanıt alınamadığında ve görme semptomları varlığında uygulanabilmektedir. Bu yazıda, ilgili radyolojik ve klinik bulgular tartışıldı ve tedavi yöntemleri kısaca gözden geçirilmiştir.
Cerebral Infarct due to Fibromuscular Dysplasia: A Case Report
(Cukurova Univ, Fac Medicine, 2013) Tay, Arzu; Tamam, Yusuf; Acar, Abdullah
The course of cervicocephalic fibromuscular dysplasia is mainly asymptomatic. It is often found as an incidental finding on autopsy or angiography mostly in women and is commonly located in extracranial region of carotid artery. In the present article, we reported a 21 year- old man who has been initially accepted to our intensive care with a tentative diagnosis of cerebrovascular infarct after having symptoms of loss of consciousness and right hemiparesis. He later received a certain diagnosis of fibromuscular dysplasia after neuroimaging findings. This disorder should be considered in differential diagnosis of young stroke patients.
Changes in serum albumin levels and neutrophil-lymphocyte ratio in patients with convulsive status epilepticus
(Taylor & Francis Ltd, 2017) Ozdemir, Hasan H.; Akil, Esref; Acar, Abdullah; Tamam, Yusuf; Varol, Sefer; Cevik, Mehmet Ugur; Arikanoglu, Adalet
Aim: Inflammation may be involved in the ictogenesis and development of some partial epilepsies. Serum albumin levels and the neutrophil-lymphocyte ratio (NLR) are markers of inflammation. The aim of this study was to investigate the ability of serum albumin levels and NLR to predict inflammation in patients with convulsive status epilepticus (CSE). Methods: This retrospective study was conducted on 58 patients who were diagnosed with CSE and control group comprised of 58 healthy individuals. Albumin levels and NLR were evaluated during both the acute and subacute periods of CSE. Results: The average serum albumin levels were 3.27 +/- 0.62 g/dL during the acute period and 3.4 +/- 0.67 g/dL in the subacute period in the patient group and 3.92 +/- 0.52 g/dL in the control group. Neutrophil counts were higher in patients in the acute phase of CSE, but lymphocyte counts were lower compared to the control group and the subacute phase. The average NLR values were 4.83 +/- 5.1 in the acute period, 3.07 +/- 3.02 during the subacute period and 1.98 +/- 0.42 in the control group. Serum albumin and NLR levels were significantly different between the patients in the subacute and acute periods of CSE and the control group (p < 0.05). There were significant negative correlational relationships between serum albumin and NLR levels (p < 0.05). Conclusion: We found serum albumin levels were significantly lower and the NLR was significantly higher in the acute period of CSE. Neutrophil-mediated inflammation may be important in the aetiopathogenesis of CSE.
The clinical features of olanzapine overdose in emergency department; a three years experience
(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2010) Uestuendag, Mehmet; Gueloglu, Cahfer; Orak, Murat; Altunci, Yusuf Ali; Dogan, Halil; Tamam, Yusuf
Objective: Since using of olanzapine becomes widespread in the world, clinical features of olanzapine intoxication become important for emergency departments. In our study, we evaluated the patients with Olanzapine intoxication retrospectively. Methods: Olanzapine overdose patients who were admitted to an emergency department between February 2004 and April 2007 were included in the study. The Poisoning Severity Score of the European Association of Poison Centers and Clinical Toxicologists was used to assess intoxication severity. Results: In our study we include fifteen olanzapine overdose patients. Female and male ratio was two (10/5). The average age was 27.33 +/- 9.27 years (range: 17-48 years). The ingested olanzapine doses ranged from 50 to 600 mg whereas the mean of admission time was 3.96 +/- 2.38 (range: 1.5-10) hours after ingestion. For a subgroup of patients ingesting olanzapine alone, The Poisoning Severity Score was 'minor' in four (44.4%), 'moderate' in four (44.4%), and 'severe' in one (11.2%) patients. While minor intoxication symptoms occurred in a broad range of ingested doses (50-75 mg), moderate intoxications were observed at a minimal ingested reported dose of 140 mg. Finally 13 patients were discharged after full recovery and two patients died. Conclusion: Our findings showed that olanzapine overdose is relatively well tolerated especially when it is not accompanied by any co-ingestant. However, it can be life threaten when it is high doses are ingested or in association with other ingestants. There is correlation between dose and clinical features or prognosis. (Anatolian Journal of Psychiatry 2010; 11:145-150)
Co-occurrence of cardiac and cerebral hydatid cysts: A case report
(Hermiston Publications Ltd, 2006) Itumur, K.; Tamam, Yusuf; Karabulut, Aziz; Güzel, Aslan; Kılıç, Nihal
Cardiac and cerebral hydatid cysts are rarely encountered. In this case, we report a male patient admitted to our hospital with hemiparesis, headache and dysphasia which occurred as a result of complications of both 3,1x3,5 cm single hydatid cyst in the left cardiac ventricle and multiple cerebral hydatid cysts (approximately 18 particles, the largest being 3 × 2,2cm). He had undergone surgery 17 month earlier due to a multiple brain hydatid cysts. Although he had been treated with albendazole, multiple cerebral hydatid cysts re-appeared 17 months after operation. This was a rare case in which left ventricular intracavitary hydatid cyst occurred together with brain multiple cysts at the same time. Physicians should be alert about the probability of cardiac involvement when a cerebral hydatid cyst is diagnosed and appropriate investigations should always be conducted.
Coexisting subarachnoid hemorrhage and subdural hematoma mimicking acute anterolateral myocardial infarction
(Churchill Livingstone Inc Medical Publishers, 2007) Iltumur, Kenan; Tamam, Yusuf; Karahan, Zulkuf; Guzel, Aslan; Altindag, Rojhat
Ischemic electrocardiographic changes, elevations in cardiac-specific markers such as troponin and creatinine phosphokinase NIB, segmental wall motion abnormalities, and myocardial dysfunction may occur after central nervous system events such as subarachnoid hemorrhage, subdural hematoma, and ischemic stroke. The pathophysiology remains unclear, but a catecholamine-induced neurocardiogenic injury has been mentioned as a causative factor. We reported a case of coexisting subarachnoid hemorrhage and subdural hematoma with ischemic electrocardiography changes, increases in cardiac-specific enzymes, and a regional wall motion abnormality despite normal epicardial coronary arteries. It is very important to differentiate neurogenic stunned myocardium from myocardial dysfunction caused by coronary artery disease in patients with intracranial hemorrhages for appropriately managing the treatment of cases. (c) 2007 Elsevier Inc. All rights reserved.
COVID-19 ve nöroloji
(Dicle Üniversitesi Tıp Fakültesi, 2021) Öztürk, Ünal; Tamam, Yusuf
Amaç: COVID-19 (SARS-CoV-2) pandemisi bütün hasta gruplarını etkilediği gibi nörolojik hastalıkları olan bireyleri de etkilemiştir. Mevcut pandemi koşullarında hem tedaviye ulaşımın güçleşmesi hem de stres faktörlerinin artışı nedeniyle kronik nörolojik bozukluğu olan hasta gruplarının yönetimi için kılavuzlara ihtiyaç duyulmaktadır. Bu yazı ile Covid-19 pandemisi sürecinde kronik nörolojik bozukluğu olan hasta gruplarında tedavi ve takip sürecini kolaylaştıracak bilgilere yer verilmesi planlanmıştır. Sonuç: Nörolojik hastalıkları olan hastaların tedavilerini nörolog kontrolü altında devam ettirmeleri, tedavi değişikliği ve tedavinin kesilmesi sürecine nöroloji uzmanının karar vermesi önerilir. Halk sağlığı önerilerine uymaları, gereklilik halinde teletıp sisteminden yararlanmaları önerilir.
CSF levels of HoxB3 and YKL-40 may predict conversion from clinically isolated syndrome to relapsing remitting multiple sclerosis
(Elsevier Sci Ltd, 2021) Tamam, Yusuf; Gunes, Betul; Akbayir, Ece; Kizilay, Tugce; Karaaslan, Zerrin; Koral, Gizem; Duzel, Berna
Introduction: Multiple sclerosis (MS) often initiates with an acute episode of neurological disturbance, known as clinically isolated syndrome (CIS). There is an unmet need for biomarkers that differentiate patients who will convert to MS and who will remain as CIS after the first attack. Methods: First attack serum and cerebrospinal fluid (CSF) samples of 33 CIS patients were collected and these patients were divided as those who converted to MS (CIS-MS, n=17) and those who continued as CIS (CIS-CIS, n=16) in a 3-year follow-up period. Levels of homeobox protein Hox-B3 (HoxB3) and YKL-40 were measured by ELISA in samples of CIS-CIS, CIS-MS, relapsing remitting MS (RRMS) patients (n=15) and healthy controls (n=20). Results: CIS-CIS patients showed significantly reduced CSF levels of YKL-40 and increased serum/CSF levels of HoxB3 compared with CIS-MS and RRMS patients. CIS-MS and RRMS patients had comparable YKL-40 and HoxB3 level profiles. Receiver operating characteristic (ROC) curve analysis showed the highest sensitivity for CSF HoxB3 measurements in prediction of CIS-MS conversion. Kaplan-Meier analysis demonstrated that CIS patients with lower CSF HoxB3 (<3.678 ng/ml) and higher CSF YKL-40 (>654.9 ng/ml) displayed a significantly shorter time to clinically definite MS. Conclusion: CSF levels of HoxB3 and YKL-40 appear to predict CIS to MS conversion, especially when applied in combination. HoxB3, which is a transcription factor involved in immune cell activity, stands out as a potential candidate molecule with biomarker capacity for MS.
DİZ ARTROSKOPİSİ SIRASINDA GELİŞEN AKUT ALT EKSTREMİTE KOMPARTMAN SENDROMUNUN NÖRALTERAPİ YAKLAŞIMI İLE TEDAVİSİ: OLGU SUNUMU
(Bilimsel Nöralterapi ve Regülasyon Derneği, 2016) Tamam, Cu¨neyt; Tamam, Yusuf
Akut alt ekstremite kompartman sendromunu diz artroskopisinin nadir ancak bilinen bir komplikasyonudur. Ameliyat sırasında kullanılan sıvının kas aralarına ektravazasyonu sonucu gelişebilen kompartman sendromunun tanısı klinik tablo ile konmaktadır. Olgumuzda fasyatomi endikedir. Hastamıza Nöral Terapi yaklaşımı ile konservatif tedavi uyguladık. Olgu sunumumuzda nöral terapinin akut alt ekstremite kompartman sendromu tedavisindeki etkinliğini değerlendirdik
Editörden
(Bilimsel Nöralterapi ve Regülasyon Derneği, 2020) Tamam, Yusuf
.Değerli BARNAT okuyucuları, Bu sayımızda Tamamlayıcı Tıbbın farklı alanlarında araş- tırmalar ile karşınızdayız. Dr. Şule ŞAHİN ONAT ve Dr. Elif UMAY ALTAŞ ‘Gİ- RİŞİMSEL İŞLEM UYGULANAN OMUZ AĞRILI HASTA- LARIN DEMOGRAFİK VE KLİNİK ÖZELLİKLERİ’ isimli çalışma ile klinikte sık karşılaşılan bir hasta grubunun de- mografik ve klinik özelliklerini gösteren bir çalışmayı bizimle paylaştılar. Dr. Fatma Gülçin URAL NAZLIKUL, Dr. Ezgi AYDIN ve Dr. Hüseyin NAZLIKUL ‘DİZ OSTEOARTRİTİ (GONART- ROZ) OLAN HASTALARDA EGZERSİZ VE TRANSKÜ- TANÖZ ELEKTRİKSEL SİNİR STİMÜLASYONU (TENS) UYGULAMASININ KARŞILAŞTIRILMASI’ isimli çalışma ile diz osteoartritinde rehabilitasyonda kullanılan iki tekniği karşılaştırarak tedavi seçeneklerinde yol gösterici bir çalışma ile bilgi dağarcığımıza katkıda bulundular. Dr. Hüma BÖLÜK ŞENLİKCİ ve Dr. Fatma Gülçin URAL NAZLIKUL ‘TOTAL KALÇA ARTROPLASTİSİ SONRASI NÖRALTERAPİ UYGULAMASI: ÖN ÇALIŞMA’ çalışması ile Nöralterapinin ortopedik rehabilitasyonunda kullanımı üzerine değerli bir çalışmaya imza atarak tecrübelerini bize aktardılar. Dr. Hayriye ALP ‘KONYA YÖRESİNDE YETİŞTİRİLEN CİVAN PERÇEMİ (MİLLEİFOLİİ HERBA) BİTKİSİNİN FİTOKİMYASAL ANALİZ SONUÇLARI’ isimli çalışma ile ül- kemiz bitki örtüsünün fitoterapik potansiyelini ortaya koyan bir çalışmaya imza attı. Fzt. Sidal KEÇECİ, Zehra YILDIZ ‘MESLEKİ KAS İSKE- LET SİSTEMİ SORUNLARININ ÇÖZÜMÜNE MANUEL TERAPİNİN VE PİLATESİN ETKİSİNİN BELİRLENMESİ’ çalışması ile manuel terapi ve pilatesin meslek hastalığına bağlı kas iskelet sistem sorunlarındaki etkinliğini vurguladılar. Yine Dr. Hayriye ALP, ‘EL CERRAHİSİ SONRASI GE- LİŞEN DİJİTAL KONTRAKTÜRDE AKUPUNKTUR UYGULAMASI’ olgu sunumu ile akupunkturun kontraktürler üstündeki etkilerini gösterdi. Yazarlarımıza katkılarından dolayı teşekkür ediyor, Nöral- terapi ve Tamamlayıcı Tıbba gönül veren tüm dostlarımızın katkılarını bekliyoruz. En kısa zamanda görüşmek üzere…. Sevgi ve saygılarımla, BARNAT ailesi adına Prof. Dr. Yusuf Tamam
Effect of rivastigmine on regional cerebral blood flow in Alzheimer's disease
(Springer, 2007) Cerci, Sevim Sureyya; Tamam, Yusuf; Kaya, Halil; Yildiz, Mustafa; Arslan, Seyfi
Cholinesterase inhibitors improve or stabilize cognitive impairment in patients with Alzheimer's disease (AD). The purpose of this study was to detect brain perfusion changes and the effects of rivastigmine, an acetylcholinesterase inhibitor on single photon emission computed tomography (SPECT) before and after treatment. Fifteen patients who fulfilled the clinical criteria for probable AD of mild to moderate severity, as put forth by the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association, and as specified by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, were included in the study. A control group of 15 healthy individuals from the same age and education range was included in the study. Before treatment was begun, Mini Mental State Examination (MMSE) tests were performed on all patients to evaluate cognitive function. All patients underwent baseline SPECT for evaluation of 25 different brain regions. Rivastigmine 3 mg/d was given for the first 4 wk of treatment; the dosage was then increased to 6 mg/d. The MMSE and SPECT were repeated 6 mo after the start of treatment. SPECT findings revealed that rivastigmine did not significantly affect brain perfusion in AD cases except in the inferior frontal lobe, despite stabilization and improvement noted in MMSE scores during treatment. Rivastigmine treatment of patients with AD did not significantly change brain perfusion as seen on SPECT, except in the inferior frontal lobe, but cognitive performance was stabilized or improved during the treatment course. These findings suggest the need for additional, larger studies to investigate the effects of acetylcholinesterase inhibitors on regional cerebral blood flow.

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