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Orgasmic Headache Responsive to Greater Occipital Nerve Blockade

HEADACHE 2009年第1期49卷 130-131页

作者： selekler, macit Kutlu, Ayse Dundar, Gulmine Kocaeli Univ Fac Med Neurol TR-41380 Izmit Turkey

We present a male with headache related to sexual activity. An injection of steroid and local anesthetic combination was applied to the greater occipital nerve of the symptomatic site. The orgasmic headache stopped af... 详细信息

关键词： headache sexual activity greater occipital nerve

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Productivity impact of headache on a heavy-manufacturing workforce in Turkey

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JOURNAL OF HEADACHE AND PAIN 2013年第1期14卷 1-6页

作者： selekler, macit H. Gokmen, Gursel Steiner, Timothy J. Kocaeli Univ Fac Med Dept Neurol Izmit Kocaeli Turkey Ford Otomotiv Sanayi AS Co Hlth Serv Golcuk Kocaeli Turkey Norwegian Univ Sci & Technol Dept Neurosci N-7034 Trondheim Norway Univ London Imperial Coll Sci Technol & Med Dept Neurosci London England

Headache disorders cause substantial productivity losses through absenteeism and impaired effectiveness at work (presenteeism). We measured productivity losses from both causes at a heavy-manufacturing company with a largely male workforce in north-western Turkey. We used the HALT Index as the survey instrument. We first assessed productivity losses by surveying the entire workforce. Because we anticipated much non-participation, we also applied HALT at the annual health-checks provided to all employees by the company's on-site health clinic. Mean age of the workforce (N = 7,200) was 31 yr. About two thirds (90% male) were manual workers rotating weekly through early, late and night shifts. One third (50% male) were clerical/managerial, working a standard 5-day week. In the first assessment, 3,939 questionnaires (54.7%) were returned with usable data. In the previous 3 months, absenteeism of a parts per thousand yen1 day was reported by 360 respondents (9.1%), of whom 4 (0.10%) recorded a parts per thousand yen45 days (average per worker: 0.92 days/yr). Presenteeism equivalent to a parts per thousand yen1 day's absence was reported by 1,187 respondents (29.4%) (average per worker: 6.0 days/yr). We estimated that 23,519 days/yr were lost in total among respondents (2.3% of workforce capacity). In the first 6 months of annual health-checks, 2,691 employees (37.4%) attended (94.4% male). Absenteeism was reported by 40 (1.5%), with 74 days lost, presenteeism by 348 (12.9%), with 1,240 days lost. We estimated that, altogether, 41,771 man-days/yr were lost in the entire workforce (2.4% of capacity;94% due to presenteeism), closely matching the earlier estimate. A small minority (5.7%) of those with headache, who were only 2.5% of the workforce, accounted for > 45% of presenteeism-related lost productivity. The high productivity losses in a largely male workforce were surprising. Possible factors were the nature of the work - manual labour for two thirds, often heavy - and

关键词： Headache disorders Burden Cost Lost productivity Work impact Global Campaign against Headache

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Cyclic alternating pattern analysis in REM sleep behavior disorder

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SLEEP AND BREATHING 2013年第1期17卷 209-215页

作者： Kutlu, Ayse Iseri, Pervin selekler, macit Benbir, Gulcin Karadeniz, Derya Kocaeli Univ Dept Neurol Fac Med TR-41380 Izmit Kocaeli Turkey Istanbul Univ Dept Neurol Cerrahpasa Fac Med Sleep Disorders Ctr TR-34098 Istanbul Turkey

Rapid eye movement (REM) sleep behavior disorder (RBD) is a type of REM parasomnia characterized by complex motor activity during REM sleep. In this study, cyclic alternating pattern (CAP) in patients with idiopathic RBD was analyzed to evaluate the expression of arousal instability of NREM sleep. A total of 31 idiopathic RBD patients and age- and gender-matched 21 control subjects were consecutively recruited. Conventional sleep polysomnographic recording parameters and CAP parameters were compared between RBD and the control group. The number of CAP cycles (120.13 +/- 113.56, p = 0.007), CAP sequences (20.9 +/- 18.15, p < 0.001), CAP index (25.14 +/- 24.44, p = 0.017), and CAP rate (24.07 +/- 13.22, p = 0.016) were all significantly higher in RBD patients compared to the control group. The increase in CAP sequences was observed in phase A2 and A3 subtypes while phase A1 subtype was significantly lower in RBD patients. A significant positive correlation was observed between disease duration with total CAP time (r = 0.289, p = 0.042) and A3 index (r = 0.32, p = 0.024). There was a negative correlation between the age and A1 index (r = -0.4491, p = 0.0001). To our knowledge this is the first polysomnographic clinical study which evaluated CAP parameters in RBD. Increased CAP rate found may be considered as a sign showing that NREM sleep may also be affected in RBD patients. Therefore, CAP analysis may be important to enlighten the pathogenesis of parasomnias.

关键词： REM sleep behavior disorder Cyclic alternating pattern Parasomnias

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Comparison of different matching methods in observational studies and sensitivity analysis: The relation between depression and STAI-2 scores

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EXPERT SYSTEMS WITH APPLICATIONS 2009年第2期36卷 1876-1884页

作者： Ankarali, Handan C. Sumbuloglu, Vildan Yazici, Ayse Canan Yalug, Irem selekler, macit Baskent Univ Fac Med Dept Biostat TR-06530 Ankara Turkey Zonguldak Karelmas Univ Fac Med Dept Biostat Zonguldak Turkey Kocaeli Univ Fac Med Dept Psychiat Kocaeli Turkey Kocaeli Univ Fac Med Norol Dept Kocaeli Turkey

In researches where two or more groups are desired to be compared, observational and randomized experiments are very frequently used. As the subjects arc randomly assigned to the groups in randomized experiments, balance is provided in observed/unobserved covariates of subjects in different groups. As the subjects cannot be randomly distributed into groups in observational studies, balance of observed/unobserved covariates between groups is not provided. This situation causes a biased estimate of the treatment effect. In this research, it is focused oil different matching methods in observational studies and elimination of observed covariate effects confounding in the group effect, and these methods arc examined comparatively. For this purpose, the effect of depression in 300 migraine patients, obtained from an observational study, oil State continuous anxiety scale scores is taken and compared with the five different matching methods. Sensitivity of results is examined and it is researched whether the effect of treatment contains any bias. When results are examined, it is seen that matching methods produce similar results due to the overlap of propensity distribution in groups, high and balanced number of subjects in groups and covariates being not so many in number. The effects of unobserved covariates do not change the effect of treatment significantly. In conclusion, it is seen that, in the estimation of group effect in observational Studies, it is possible to eliminate the effects of observed covariates using matching methods and matching quality of matching methods based on the propensity score is high. (C) 2007 Elsevier Ltd. All rights reserved.

关键词： Matching methods Propensity scores Sensitivity analysis Nearest-neighbor matching Observational Studies

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Phenotypic features of chronic migraine

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JOURNAL OF HEADACHE AND PAIN 2016年第1期17卷 1-6页

作者： Yalin, Osman Ozgur Uluduz, Derya Ozge, Aynur Sungur, Mehmet Ali selekler, macit Siva, Aksel Istanbul Educ & Res Hosp Neurol Dept Kasap Ilyas Mah Org AbdurrahmanNafiz grman Cd TR-34098 Istanbul Turkey Istanbul Univ Cerrahpasa Med Sch Neurol Dept Istanbul Turkey Mersin Univ Sch Med Neurol Dept Mersin Turkey Duzce Univ Sch Med Biostat Dept Duzce Turkey Kocaeli Univ Sch Med Neurol Dept Kocaeli Turkey

Background: Chronic migraine is a disabling, under-recognized, and undertreated disorder that increases health burdens. The aim of this study was to evaluate phenotypic features and the relevance of accompanying symptoms of migraine attacks in chronic migraine. Method: This study was conducted as part of an ongoing Turkish Headache Database Study investigating the clinical characteristics and outcomes of headache syndromes in the Turkish population. The electronic database was examined retrospectively, and 835 patients with chronic migraine were included. Results: Patient group consisted of 710 women and 125 men (85 and 15 %, respectively). Mean patient age was 36.8 +/- 13.5 years, median value of migraine onset was 60 months (18-120), median headache frequency was 25 days per month (16-30), median of attack duration was 12 h (4-24), and median of intensity was eight (7-9). Increasing headache days per month were inversely related with the presence of nausea, vomiting, phonophobia, and photophobia. Longer duration of headache (months) and higher visual analog scale (VAS) for headache intensity were associated with all accompanying symptoms. Phonophobia, nausea, photophobia, and vomiting were the most frequent accompanying symptoms (experienced by 80.2, 77.6, 71.2, and 40.9 % of patients, respectively). Osmophobia was also frequent in chronic migraine patients (53.4 %) and was closely associated with other accompanying symptoms. Vertigo and dizziness were observed less frequently, and they were not associated with accompanying symptoms. Conclusion: Phenotype of chronic migraine may be associated with the course of chronification. Duration of illness and attack intensity were closely related with the presence of accompanying symptoms, although headache frequency was found to be inversely related to the presence of accompanying symptoms. Osmophobia was also a frequent symptom and was closely related with other accompanied symptoms, unlike vertigo and dizziness. Inclusi

关键词： Chronic migraine Phenotype Accompanying symptoms Chronification

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Correlations between alexithymia and pain severity, depression, and anxiety among patients with chronic and episodic migraine

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PSYCHIATRY AND CLINICAL NEUROSCIENCES 2010年第3期64卷 231-238页

作者： Yalug, Irem selekler, macit Erdogan, Ayten Kutlu, Ayse Dundar, Gulmine Ankarali, Handan Aker, Tamer Kocaeli Univ Fac Med Dept Psychiat Kocaeli Turkey Kocaeli Univ Fac Med Dept Neurol Kocaeli Turkey Karaelmas Zonguldak Univ Fac Med Dept Psychiat Zonguldak Turkey Karaelmas Zonguldak Univ Fac Med Dept Biostat Zonguldak Turkey

Aims: Some studies have found elevated alexithymia among patients with chronic pain, but the correlations between alexithymia and the severity of pain, depression, and anxiety among migraine patients are unclear. The aims of the present study were to investigate whether individuals suffering from episodic migraine (EM) differ from those with chronic migraine (CM) in regards to depression, anxiety, and alexithymia measures and to investigate the association of alexithymia with the results of depression and anxiety test inventories and illness characteristics. Methods: A total of 165 subjects with EM and 135 subjects with CM were studied. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Toronto Alexithymia Scale (TAS) were administered to all subjects. The correlation between alexithymia and sociodemographic variables, family history of migraine and illness characteristics (pain severity, frequency of episode, duration of illness) were evaluated. Results: Compared with EM patients, the CM patients had significantly higher scores on measures of depression but not alexithymia and anxiety. There was a positive correlation between TAS scores and age and education in both migraine groups, but there was no correlation between TAS scores and other demographic variables. Depression and anxiety were significantly correlated with alexithymia in both migraine groups. Conclusion: Our results indicate that CM patients are considerably more depressive than EM patients. In this study, depression and anxiety were significantly correlated with alexithymia in both migraine groups. Our results demonstrate a positive association between depression, anxiety, and alexithymia in migraine patients.

关键词： alexithymia anxiety depression migraine

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Silent cerebral infarction in chronic heart failure: Ischemic and nonischemic dilated cardiomyopathy

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VASCULAR HEALTH AND RISK MANAGEMENT 2008年第2期4卷 463-469页

作者： Kozdag, Guliz Ciftci, Ercument Ural, Dilek Sahin, Tayfun selekler, macit Agacdiken, Aysen Demirci, Ali Komsuoglu, Sezer Komsuoglu, Baki Kocaeli Univ Med Fac Dept Cardiol Cardiol Kocaeli Turkey Kocaeli Univ Med Fac Dept Cardiol Radiol Kocaeli Turkey Kocaeli Univ Med Fac Dept Cardiol Neurol Kocaeli Turkey

Objectives: Patients with dilated cardiomyopathy (DCM) may have a high incidence of clinically asymptomatic silent cerebral infarction (SCI). Prevalence of SCI and its risk factors may differ between ischemic and nonischemic DCM. The purpose of this study was to evaluate prevalence and related parameters of silent cerebral infarction in patients with ischemic and nonischemic DCM. Methods: Patients with ischemic and nonischemic DCM (53 male, 19 female, aged 62 +/- 12 years) were included in the study. Etiology of DCM was ischemic in 46 and nonischemic in 26 patients. Fifty-six age-and gender-matched healthy volunteers served as a control group for comparison of SCI prevalence. Results: Prevalence of SCI was 39%, 27%, and 3.6% in ischemic, nonischemic DCM, and control group, respectively (ischemic DCM vs control group, p < 0.001, nonischemic DCM vs control group, p = 002). In patients with nonischemic DCM, the mean age of the subjects with SCI was significantly higher than that of subjects without lesions (67 +/- 5 years vs 53 +/- 13, p < 0.001), whereas in ischemic DCM NHYA Functional Class was statistically higher in patients with SCI than without SCI (p = 0.03). In both groups, patients with SCI had lower systolic functions than patients with normal MRI findings. In multivariable logistic regression analysis, restrictive type of diastolic filling pattern was found as an independent factor for SCI occurrence on the whole patient population (OR: 16.5, 95% CI: 4.4-61.8, p < 0.001). Conclusion: SCI is common in patients with both ischemic and nonischemic DCM. In univariate analysis, both groups have similar systolic and diastolic characteristics in the occurrence of SCI. Logistic regression analysis revealed that restrictive diastolic filling pattern is an independent risk factor in the occurrence of SCI for the whole patient population.

关键词： ischemic dilated cardiomyopathy nonischemic dilated cardiomyopathy silent cerebral infarction restrictive diastolic filling age functional status

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Gender differences in older adults with chronic migraine in Turkey

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GERIATRICS & GERONTOLOGY INTERNATIONAL 2015年第5期15卷 652-658页

作者： Ozge, Aynur Uluduz, Derya selekler, macit Ozturk, Musa Baykan, Betul Cinar, Nilgun Domac, Fusun M. Zarifoglu, Mehmet Inan, Levent E. Akyol, Ali Bolay, Hayrunnisa Uzuner, Gulnur T. Erdemoglu, Ali K. Oksuz, Nevra Temel, Gulhan O. Mersin Univ Dept Neurol Sch Med Mersin Turkey Mersin Univ Dept Biostat Sch Med Mersin Turkey Cerrahpasa Sch Med Dept Neurol Istanbul Turkey Atasehir Mem Hosp Istanbul Turkey Bakirkoy Res & Educ Hosp Dept Neurol Istanbul Turkey Istanbul Univ Dept Neurol Istanbul Fac Med TR-34340 Istanbul Turkey Maltepe Univ Dept Neurol Sch Med Istanbul Turkey Erenkoy Res & Educ Hosp Dept Neurol Istanbul Turkey Uludag Univ Dept Neurol Sch Med Bursa Turkey Ankara Res & Educ Hosp Dept Neurol Ankara Turkey Adnan Menderes Univ Dept Neurol Sch Med Aydin Turkey Gazi Univ Dept Neurol Sch Med Ankara Turkey Osmangazi Univ Dept Neurol Sch Med Eskisehir Turkey Med Pk Hosp Ankara Turkey

Aim: Chronic migraine is a growing and disabling subtype of migraine with different risk factors and clinical features, even in older adults. We sought to define and differentiate clinical features of chronic migraine in older adults. We also aimed to compare major clinical features of chronic migraine in older adults with those in younger people of both sexes. Methods: We used electronic dataset (Turkish Headache Database) from 13 tertiary headache centers in Turkey. Electronic dataset included detailed headache-defining features according to ICHD-II criteria based on face-to-face interviews and examination by a headache specialist. Using statistical methods, clinical variables of chronic migraine in older adults were compared with those of younger adults. We included 915 patients with chronic migraine (mean age 43.80 +/- 13.95 years);83.3% were females. In total, 301 patients (32.9%) with chronic migraine aged >50 years were compared with 614 patients aged <50 years. Results: There was no significant change in men with increasing age. However, duration of headache history, severity of attacks, previous histories of motion sickness and positive family history of headaches were significantly different in women with increasing age. Further sex-related differences have been shown in parameters such as attack duration, quality and associated nausea. Conclusion: Chronic migraine is an infrequent type of migraine and shows age-related changes in some phenotypic characteristics, such as severity of attacks, especially in women aged older than 50 years. Furthermore, positive family history of headaches and history of motion sickness increase the likelihood of developing chronic migraine in older women, indicating involvement of some gender-related, but as-yet unknown, genetic factors.

关键词： chronic migraine elderly gender headache phenotype women

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Single-dose intravenous tramadol for acute migraine pain in adults: A single-blind, prospective, randomized, placebo-controlled clinical trial

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CLINICAL THERAPEUTICS 2007年第7期29卷 1441-1447页

作者： Alemdar, Murat Pekdemir, Murat selekler, Hamit macit Kocaeli Univ Hosp Fac Med Dept Neurol Kocaeli Turkey Kocaeli Univ Fac Med Dept Emergency Med Kocaeli Turkey

Background: Tramadol, an atypical oploid, is a narcotic analgesic used for pain management. A search of the current literature found no studies examining the efficacy of intravenous tramadol on migraine pain. Objective: The aim of this study was to investigate the efficacy and tolerability of a single dose of intravenous tramadol hydrogen chloride 100 mg in comparison with placebo in patients presenting with migraine. Methods: Adult migraineurs admitted consecutively to the emergency department of the Kocaeli University Hospital were enrolled in this single-blind (patients), prospective, randomized, placebo-controlled clinical trial. Patients were randomized to receive a 30-minute infusion of either intravenous tramadol (n = 17;100 mg in 100-mL saline) or placebo (n = 17;100-mL saline). Pain response was defined as a decrease of visual analogue scale (VAS) (0-100 mm) score to <50% of the pretreatment (baseline) value and a decrease of 4-point verbal scale (FPVS) score (0 = none, 1 = mild, 2 = moderate, 3 = severe) to mild or none. Pain-free response was defined as a decrease of both VAS and FPVS scores to 0. Pain was assessed at baseline and at 30 minutes and 1 hour after treatment completion. Migraine symptoms (eg, photophobia, phonophobia, nausea, vomiting) and adverse events (AEs) were assessed at the same time. A follow-up was also conducted by phone 24 hours after treatment. Results: Forty-four migraineurs were screened and 34 (28 women and 6 men;mean [SD] age, 39.5 [10.4] years;all were white) were enrolled in the study. Each group contained 11 patients with severe pain and 6 patients with moderate pain at baseline FPVS. At the end of 1 hour, pain response was reported by significantly more patients in the tramadol group than in the placebo group (12 [70.6%] vs 6 [35.3%];P = 0.040). Pain-free response was reported by 5 (29.4%) patients in the tramadol group and 2 (11.8%) patients in the placebo group, although the difference was not statistically significant.

关键词： migraine headache tramadol placebo

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Unconventional treatment methods in Turkish migraine sufferers

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Journal of Headache and Pain 2004年第3期5卷 197-200页

作者： selekler, H. macit Komsuoğlu, Sezer Department of Neurology Kocaeli University Medical Faculty Derince 41900 Kocaeli Dekanlik Binasi Turkey

We wanted to document Turkish migraine sufferers' unconventional therapy methods learnt from their social environment and discuss the historical background and possible action mechanisms of these methods. Unconventional therapy methods were documented among 482 migraine patients who consulted Kocaeli University Medical Faculty, Neurology Department's "Headache outpatient clinic". Among 482 migraine patients, 154 sufferers (31.9%) had been using unconventional therapy methods. Among these patients, the most frequently used methods were using a head bandage (25.9%), applying cold water to head (23.4%), massage (16.2%), applying ice to head (15.6%), taking a hot or warm bath (10.4%) and inserting sliced vegetables under the head bandage (7.8%). However, our data may not represent all Turkish migraine sufferers as our sample was drawn from a clinical sample living in the most western part of Anatolia, the city of Kocaeli bordering Istanbul. Determining the efficacy of these methods was beyond our aim;however, a more systematic study about the given case may be even more interesting. © Springer-Verlag Italia 2004.

关键词： Bath Cold water Head bandage Ice Massage Migraine

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