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Öğe A Rare Combination: Myocardial Infarction and Cerebral Ischemia(Düzce Üniversitesi, 2012) Bulur, Serkan; Ercan, Nurten; Büyükkaya, Ramazan; Dikici, SüberMyocardial infarction (MI) is death of heart cells due to the decreased blood flow to a part ofthe heart. Reduction in blood flow increases the oxygen demand of the heart and if it leftuntreated for a sufficient period of time, can cause damage or death of heart muscle tissue.Cerebral ischemia,represents metabolic damage in the brain as a result of insufficient bloodflow. Cerebral hypoxia leads to death of brain tissue that named cerebral infarction. Symptomsof brain ischemia can include unconsciousness (from somnolance to stupor), blindness,coordination problems, body weakness, cardiorespiratory arrest and irreversible brain damage.Observation of cerebral ischemia and MI are a rare combination. Combination of MI andcerebral ischemia is a rare situation we evaluated the case in light of recent literatureÖğe Adverse effects of energy drinks(W B Saunders Co-Elsevier Inc, 2015) Sarıtaş, Ayhan; Dikici, Süber; Güneş, Harun…Öğe Amlodipine-induced Delirium in a Patient With Ischemic Stroke(Lippincott Williams & Wilkins, 2012) Dikici, Süber; Kocaman, Gülşen; Özdem, Şeyma; Koçer, AbdulkadirAmlodipine is a dihydropyridine calcium antagonist drug with distinctive pharmacokinetic characteristics that seem to be attributable to a high degree of ionization. Delirium is a neuropsychiatric syndrome recognized as a marker for increased health care costs, morbidity, mortality, and institutionalization that often complicates acute physical illness in elderly people. This case is the first report concerning amlodipine use as a cause of delirium.Öğe Association of anxiety, sleepiness, and sexual dysfunction with restless legs syndrome in hemodialysis patients(Wiley-Blackwell, 2014) Dikici, Süber; Bahadır, Anzel; Baltacı, Davut; Ankaralı, Handan; Eroğlu, Mustafa; Ercan, Nurten; Sav, TansuRestless legs syndrome (RLS) is characterized by unpleasant sensations, pain in the legs along with irresistible urges to move the legs when at rest. It is often accompanied by sleep disturbance. The purpose of this study was to assess the association of anxiety and sleepiness with sexual function in hemodialysis patients with and without RLS. Sociodemographic parameters, laboratory data of hemodialysis patients from three dialysis centers were collected prospectively. Anxiety, sleepiness, sexual function, and presence of RLS symptoms were assessed with standardized questionnaires as the RLS Diagnosis and Scale, Hamilton Anxiety Rating Scale, Epworth Sleepiness Scale (ESS), Arizona Sex Experiences Scale (ASEX). Univariate, regression tree method were used for statistical analysis. RLS was observed in 45.9% (n=113) of hemodialysis patients (n=246). The mean age of patients and duration of hemodialysis were 59.7 +/- 14.0 and 4.9 +/- 4.2 years, respectively. The correlation between Arizona Sexual Experiences Scale (ASEX) and sociodemographic features was significant (P<0.0001). Patients with RLS had higher scores for anxiety (9.4 +/- 7.8 with RLS and 6.8 +/- 6.0 without), higher ESS (ESS, 6.6 +/- 5.2 with RLS and 4.6 +/- 4.0 without), and higher ASEX (24.6 +/- 5.7 with RLS and 22.5 +/- 6.8 without) than did those without RLS. The presence of RLS symptoms in hemodialysis patients was associated with sleepiness, anxiety, and sexual dysfunction. A regression tree method, which is a different statistical method, can help physicians estimate patients ASEX, RLS, ESS, and anxiety scores.Öğe Association of Endothelial Nitric Oxide Synthase Gene Polymorphisms (894G/T,-786T/C, G10T) and Clinical Findings in Patients with Migraine(Humana Press Inc, 2014) Eröz, Recep; Bahadır, Anzel; Dikici, Süber; Tasdemir, SenerMigraine is a common neurological disorder characterized by recurrent attacks, unilateral head pain, and related symptoms. The aim of this study was to investigate three endothelial nitric oxide synthase (eNOS) polymorphisms in 176 patients with migraine and 123 healthy individuals. Clinical and biochemical parameters were investigated. Genetic analysis was performed using the polymerase chain reaction-restriction fragment length polymorphism method. The differences between migraine cases and the control group were significant for two polymorphisms (-786T/C and 894G/T) (p = 0.000). Homocysteine and body mass index (BMI) were significantly higher in the migraine group than in the control group (p = 0.001 and p = 0.000). The relation between -786T/C genotype and BMI and allodynia was significant. TC heterozygotes and CC homozygotes were significantly higher in the migraine group than in the control group (OR 2.843 and 95 % CI 1.681-4.808 and OR 3.729 and 95 % CI 1.784-7.792, respectively). The 894G/T genotype was correlated with BMI, pain intensity, age at the onset of migraine, nausea, tension, compression, and allodynia. For this polymorphism, GT heterozygotes and TT homozygotes were significantly higher in the migraine group than in the control group (OR 3.027 and 95 % CI 1.830-5.008 and OR 3.221 and 95 % CI 1.223-8.484, respectively). The G10T genotype was correlated with attack duration and age at the onset of migraine (p = 0.008 and p = 0.040). eNOS polymorphisms may be useful markers for assessing migraine risk and clinical diagnosis.Öğe Association of mean Platelet volume with DSM-IV major depression in a large community-based population: The MELEN study(Pergamon-Elsevier Science Ltd, 2012) Canan, Fatih; Dikici, Süber; Kutlucan, Ali; Celbek, Gökhan; Coşkun, Hülya; Güngör, Adem; Kocaman, GülşenThe relationship between major depression and increased platelet activity has been previously stated by several studies. This study sought to test the relationship between mean platelet volume (MPV) - an indicator of platelet activity - and major depression, in an adult Turkish population sample. Respondents were 2286 participants interviewed in a regional survey. The diagnosis of current (one month) major depression was made according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. MPV was measured along with total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, BMI, and waist circumference. Two hundred eighty-nine participants (12.5%) were diagnosed as having major depression. Patients with major depression were found to have increased MPV levels in comparison with participants without depression (p = 0.001). After excluding the subjects with risk factors capable of influencing platelet activity. MPV was still found to be elevated in patients with major depression compared with non-depressed individuals (p < 0.01). Linear regression analysis revealed a significant independent association of major depression with MPV levels (r = 0.123: p = 0.001). According to the findings of this study, increased MPV (or platelet activation) is associated with current (one month) diagnosis of major depression. Future research should investigate the effect of depression treatment on MPV. (C) 2011 Elsevier Ltd. All rights reserved.Öğe Atypical preeclampsia and eclampsia: Report of four cases and review of the literature(2010) Albayrak, Mustafa; Özdemir, İsmail; Demiraran, Yavuz; Dikici, SüberKlinik olarak preeklampsi (hipertansiyon ve proteinüri) geliştiren çoğu kadında bulgular 20 gebelik haftasından postpartum 48 saate kadar ortaya çıkar ve bu özellikle diğer yönlerden sağlıklı nullipar gebelerde böyledir. Son bazı çalışmalarda preeklampsi ve hatta eklampsinin hipertansiyon ve proteinüri olmadan gelişebileceği gösterilmiştir. Burda biz dört atipik vaka takdim ettik: proteinüri ve hipertansiyon olmadan eklampsi (olgu 1), hipertansiyon olmaksızın proteinüriyi takip eden parsiyel eklampsi nöbeti (olgu 2), fetal distresle gelen ancak hipertansiyon olmayan bir vaka (olgu 3) ve hızlı gelişen tedaviye yanıt vermeyen masif proteinüri vakası (olgu 4). Atipik eklampsideki problem tahmin edilemeyen ortaya çıkışıdır, o nedenle zamanında tanı ve müdahale komplikasyonları engellemek için elzemdir. Bu yazının amacı gebelikteki atipik hipertansif durumlar hakkındaki bilinci arttırmaktır.Öğe Atypical preeclampsia and eclampsia: Report of four cases and review of the literature(2010) Albayrak, Mustafa; Özdemir, İsmail; Demiraran, Yavuz; Dikici, SüberClassically,most women who develop preeclampsia (hypertension and proteinuria) present some time after 20 weeks of gestation up to 48 h postpartum;and this is especially true in otherwise healthy,nulliparous pregnancies.Recent data suggest that in some women,preeclampsia and even eclampsia may develop in the absence of hypertension or proteinuria.Here,we report four atypical cases:Eclampsia in the absence of hypertension and proteinuria(case1),a partial seizure following eclampsia with antecedent proteinuria, but no hypertension(case2),a case presenting with fetal distress,but no hypertension(case3),and a case with unusually rapid progression and massive proteinuria that was unresponsive to therapy(case4).Problems with atypical forms of eclampsia lie in its unpredictable onset;Timely diagnosis and management are critical in avoiding complications.The purpose of this review is to increase he awareness of atypical forms of hypertensive disorders during pregnancy.Öğe CAN POOR SLEEP QUALITY SUGGEST DEPRESSION IN ELDERLY PATIENTS UNDERGOING HEMODIALYSIS?(Gunes Kitabevi Ltd Sti, 2013) Dikici, Süber; Aydın, Leyla Yılmaz; Bahadır, Anzel; Baltacı, Davut; Eroğlu, Mustafa; Ercan, NurtenIntroduction: Sleep disorders increase with aging. Comorbidities cause a further increase in sleep disturbance. The aim of the study was to evaluate the relationship between subjective sleep quality and depression in subjects aged older than 65 years and undergoing hemodialysis. Materials and Method: Socio-demographic data of participants were recorded in this cross-sectional study. The Pittsburg Sleep Quality Index and the Beck Depression Inventory were administered face to face. Vital measures and Body Mass Index calculations were completed. Blood samples were taken for hemogram, biochemical parameters. Results: Fifty two female and 47 male patients were included in the study. Their mean age was 72.11+/-5.79 years. The mean Beck Depression Inventory score was 11.95+/-6.80. Mild, moderate and severe depression, as measured by the Beck Depression Inventory, were 77.8%, 20.2% and 2% of patients, respectively. The mean Pittsburg Sleep Quality Index was 7 (3-12). Those with good and poor sleep quality were 40.4% and 59.6%, respectively. Statistically significant differences were not found between age, duration of dialysis, body mass index, and systolic and diastolic arterial blood pressures, and sleep quality. There was a statistically significant difference between sleep quality and Beck Depression Inventory (p=0.000). Moderate to severe depression was detected in 32.2% of poor sleepers and only 7.5% of good sleepers. Conclusion: The quality of sleep is significantly impaired in elderly patients undergoing hemodialysis. Advanced age, with co-morbid diseases, adversely affects the quality of sleep. Poor sleep quality and depression trigger each other. The quality of life in elderly end stage renal failure patients can be improved and possible morbidity can be prevented by investigating patients' quality of sleep to diagnose a possible depression.Öğe Carbonmonoxide Post-interval Syndrome(Coll Physicians & Surgeons Pakistan, 2015) Sağlam, Sadullah; Cortuk, Mustafa; Güneş, Harun; Çolak, Şahin; Kandiş, Hayati; Sarıtaş, Ayhan; Dikici, Süber…Öğe A Case of Ciprofloxacin Induced Delirium(Duzce Univ, 2015) Dikici, Süber; Sağlam, Esra; Arslan, Güven; İnce, Nevin; Kılıç, ŞeymaA previously healthy 82-year-old woman presented with acute-onset delirium with psychotic features as a consequence of ciprofloxacin therapy. Withdrawal of the medication was associated with return of the patient's normal mental status. The quinolones called gyrase inhibitors are known for their potential to cause central nervous system-related adverse effects, including headache and insomnia. Risk factors for neurotoxicity include renal insufficiency, underlying central nervous system (CNS) disease and increased CNS penetration of drug. Acute delirium resulting from ciprofloxacin therapy is an exceedingly rare complication that has been thought to occur more commonly in elderly patients. Herein, we described that a ciprofloxacin induced delirium case after ciprofloxacin use.Öğe Comparison of smoking habits, knowledge, attitudes and tobacco control interventions between primary care physicians and nurses(European Publishing, 2015) Sönmez, Cemil Işık; Aydın, Leyla Yılmaz; Türker, Yasemin; Baltacı, Davut; Dikici, Süber; Sarıgüzel, Yunus Cem; Demir, MustafaBackground: Primary care providers are uniquely positioned to initiate smoking cessation. We aimed to evaluate knowledge levels about the health effects of smoking and attitudes toward smoking and tobacco control activities among primary care providers. Methods: In the cross-sectional and primary care-based study, self-administered surveys modified from the WHO Global Health Professional Survey 5A steps of smoking cessation practice (Ask, Advise, Assess, Assist and Arrange) were provided to primary care physicians (PCPhs) and nurses (PCNs). Results: Respondents included 1182 PCPhs and 1063 PCNs. The proportions of current and former smokers were significantly higher among PCPhs than among PCNs (34.4 vs. 30.7 % and 14.0 vs. 10.1 %, respectively; both P < 0.001). We observed that 77.2 % of PCPhs and 58.4 % of PCNs always or rarely practiced an "Ask" step about their patients' smoking status (P < 0.001). One-third of PCPhs (33.8 %) stated that they always practiced an "Ask" step, whereas only 27.6 % of PCNs always did so in their practice (P < 0.001). A small minority of primary care providers had advised patients to quit smoking, although there was a significant difference in this between PCNs and PCPhs (8.4 vs. 15.6 %; P < 0.001). Most PCPhs considered themselves competent in advising about smoking interventions, but only a minority of PCNs did so (75.1 vs. 17.3 %; P < 0.001). Among barriers to tobacco intervention measures, lack of time was the item most commonly cited by PCPhs, whereas low patient priority was most commonly cited by PCNs (35.9 and 35.7 %; P < 0.001). Conclusions: Smoking intervention practice by primary care nurses was quite low. Lack of time and low patient priority were identified as barriers by primary care providers. Strategies by which primary care providers could improve tobacco control should be established.Öğe Congenital Long QT Syndrome Referred with Sudden Cardiac Arrest(Düzce Üniversitesi, 2014) Gür, Mücahit; Kutlucan, Leyla; Kandiş, Hayati; Türker, Yasin; Aydın, Leyla Yılmaz; Dikici, Süber; Kaya, ErtuğrulThe long QT syndrome (LQTS) is characterized with arrhythmic attacks, repeating syncopes,seizures, and ventricular arrhythmias leading to sudden death. Arrhythmias with a potential ofmortal course develop due to elongation of ventricular repolarization, either acquired or inborn.Herein the present paper, a case of congenital LQTS, admitted after a sudden cardiac arrest andtotally recovered with implantable cardiac defibrillator (ICD), was focused onÖğe Do energy drinks cause epileptic seizure and ischemic stroke?(W B Saunders Co-Elsevier Inc, 2013) Dikici, Süber; Sarıtaş, Ayhan; Beşir, Fahri Halit; Taşçı, Ahmet Hakan; Kandiş, HayatiEnergy drinks are popular among young individuals and marketed to college students, athletes, and active individuals between the ages of 21 and 35 years. We report a case that had ischemic stroke and epileptic seizure after intake of energy drink with alcohol. To the best of our knowledge, the following case is the first report of ischemic stroke after intake of energy drink. A previously healthy 37-year-old man was brought to the emergency department after a witnessed tonic-clonic seizure. According to his wife's testimony, just before loss of consciousness, the patient had been drinking 3 boxes of energy drinks (Redbull, Istanbul, Turkey, 250 mL) with vodka on an empty stomach. He did not have a history of seizures, head trauma, or family history of seizures or another disease. In cranial diffusion magnetic resonance imaging, there were hyperintense signal changes in bilateral occipital area (more pronounced in the left occipital lobe), right temporal lobe, frontal lobe, and posterior parietal lobe. All tests associated with possible etiologic causes of ischemic stroke in young patients were negative. Herein, we want to attract attention to adverse effect of energy drink usage.Öğe Does an energy drink cause a transient ischemic attack?(W B Saunders Co-Elsevier Inc, 2015) Dikici, Süber; Sarıtaş, Ayhan; Kılınç, Şeyma; Güneysu, Semih; Güneş, HarunEnergy drinks have become a popular beverage especially among young individuals. The growing literature sheds light on acute health problems associated with these products, although they have not yet been in existence long enough to build a solid, evidence-based appreciation of potential long-term effects. Perhaps the greatest concern about energy drinks is the amount of caffeine they contain, which generally far exceeds that in other beverages. A transient ischemic attack (TIA) has been traditionally defined as an episode of neurologic dysfunction caused by focal cerebral ischemia with complete recovery within 24 hours. We report a patient who had a TIA after intake of an energy drink without alcohol. To the best of our knowledge, the following case is the first report of TIA after intake of an energy drink.Öğe Dual Diagnosis: Rheumatoid Arthritis and Multiple Sclerosis(Elsevier Science Inc, 2014) Özşahin, Mustafa; Dikici, Süber; Kocaman, Gülşen; Beşir, Fahri Halit; Baltacı, Davut; Ataoğlu, SafinazJuvenile rheumatoid arthritis (JRA) is the most common rheumatologic disease in children. Moreover, multiple sclerosis (MS) is the most frequent demyelinating disease and has been associated with various chronic inflammatory diseases: However, its association with JRA. has not been frequently described. Autoimmunity in both JRA and MS has been documented in the scientific literature, although there has been no definitive finding that patients with JRA are prone to the development of MS. An increasing frequency of MS resulting from an increased use of antitumor necrosis factor agents in the treatment of rheumatoid arthritis and other chronic inflammatory diseases has been reported recently. In this study, we report on the development of MS in a patient with JRA who did not have a history of antitumor necrosis factor use.Öğe Düzce İli Migren Tanısı Almış Hastalarda ENOS Ekzon (G894T) Polimorfizminin Araştırılması(2012) Bahadır, Anzel; Eröz, Recep; Dikici, SüberAmaç: Düzce ili migrenli hastalarda eNOS ekzon (G894T) polimorfizm-hastalık ilişkisinin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya 51 migrenli hasta ve 51 sağlıklı birey dâhil edilmiştir. Bireylerin DNA'sı izole edilerek, eNOS ekzon (G894T) polimorfizmini içeren gen bölgesi PCR yöntemi ile çoğaltıldıktan sonra, Mbo I restriksiyon enzim kesim reaksiyonu ile genotip analizleri gerçekleştirilmiştir. Bulgular: Migren ve kontrol grupları arasında yaş (p0,70), cinsiyet (p0,529), homosistein (p0,250) ve trigliserit (p0,575) değerleri açısından anlamlı bir farklılık bulunmamıştır. Kontrol ve migren grubu arasında eNOS ekzon (G894T) polimorfizmi açısından anlamlı bir farklılık (p0,0001) gözlenirken, migren auralı (MA) ve migren aurasız (MO) grubu arasında anlamlı bir farklılık (p0,377) saptanmamıştır. Bu polimorfizm ile hem cinsiyet (p0,760) hem de aile öyküsü arasında (p0,380) bir farklılık belirlenmemiştir. Sonuç: Düzce ili popülasyonundaki migrenli hastalar ile eNOS ekzon (G894T) polimorfizmi arasında anlamlı bir ilişki (p0,0001) belirlenmiştir. Gelecek araştırmalarda, migren oluşumunu tetikleyici diğer aday genlerin de (MTHFR, ACE vb) yöremizdeki daha fazla hasta serisinde çalışılması öngörülmektedir.Öğe Enerji içecekleri hakkında neler biliyoruz?(2012) Dikici, Süber; Yılmaz, Leyla Aydın; Kutlucan, Ali; Ercan, NurtenGenç erişkinler arasında popüler olan enerji içecekleri, özellikle 21-35 yaş arası üniversite öğrencilerine, atletlere ve aktif kişilere pazarlanmaktadır. Enerji içeceklerinin kullanımı başlangıçta fiziksel ve mental performansı belirgin olarak artırabilir. Enerji içeceklerinin ana bileşenlerini ginkgo ve gingsengin oluşturduğu bitkisel ürünler oluşturmuş olup, kafein ve guarana içeren gibi bileşenler karışımını içerir Ne yazık ki enerji içeceklerinin vücut üzerine etkileri ile ilgili literatür sınırlıdır ve bu iyileşmenin kafein veya diğer bitkisel içeriklere bağlı olup olmadığı bilinmemektedir. Alkol ile enerji içeceklerinin beraber kullanımı sonrası ciddi klinik tablolar ortaya çıkabilir. Bu makalenin amacı; enerji içeceklerinin içerikleri ve kullanımı sonrasın da oluşabilecek klinik tablolarla ilgili farkındalığı artırma ve bilgileri güncellemektir.Öğe The eNOS gene polymorphisms (exon 894 G/T, promoter-786T/C, and intron G10T) in migraine cases of a Turkish population(Wiley-Blackwell, 2014) Eröz, Recep; Bahadır, Anzel; Dikici, Süber; Koçer, A.…Öğe The eNOS gene polymorphisms (exon 894 G/T, promoter-786T/C, and intron G10T) in migraine cases of Turkish population(Springer Heidelberg, 2014) Eröz, Recep; Bahadır, Anzel; Dikici, Süber; Koçer, A.…
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