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

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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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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Poster presentations

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Surgical and radiologic anatomy : SRA 2009年第1期31 Suppl 1卷 95-229页

作者： Funda Aksu Hakan Topacoglu Candan Arman Aytul Atac Suleyman Tetik Aida Hasanovic Amela Kulenovic Zakira Mornjakovic Branko Pikula Aida Sarac-Hadzihalilovic Alma Voljevica Belgin Bamac Tuncay Colak Murat Alemdar Gulmine Dundar macit selekler Ozgur Dincer Enis Colak Aydin Ozbek Cenk Kilic Kivanc Kamburoglu Tuncer Ozen Vatan Kavak Yalcin Kirici Emin Oztas Handan Altinkaya Soysal Erdogan Unur Nihat Ekinci Omur Karaca Olga Malakhova Murat Kocaoglu Serdar Toker Figen Taser Volkan Kilincoglu Mustafa Fahri Yurtgun Cannur Dalcik Ali Zeybek Marc Baroncini Johann Peltier Patrice Jissendi Jean-Pierre Pruvo Jean-Paul Francke Vincent Prevot Rengin Kosif Yasin Arifoglu Murat Diramali Mustafa Sarsilmaz Evren Kose Murat Ogeturk Burhan Akpinar Ilter Kus Sedat Meydan Alev Kara Zeliha Kurtoglu Ibrahim Tekdemir Alaittin Elhan Orhan Bas Ersan Odaci Hakan Mollaoglu Kagan Ucok Suleyman Kaplan Mehmet Senoglu Vedat Nacitarhan Ergul Belge Kurutas Nimet Senoglu Idris Altun Yalcin Atli Davut Ozbag Sacide Karakas M Dincer Bilgin Ayfer Metin Tellioglu Sercin Ozlem Betul Akcanal Yuksel Yildiz Hakki Gunes Hayrullah Kose Ibrahim Uzum Umit Naci Gundogmus Cigdem Caglayan Velichka Pavlova Mashenka Dimitrova Lilia Georgieva Elena Nikolova Deniz Uzmansel Nail Can Ozturk Canan Yurttas Saylam Erkin Ozgiray Mustafa Orhan Sedat Cagli Mehmet Zileli Derya Ozkan Taylan Akkaya Ayhan Comert Nilgun Balikci Esra Ozdemir Haluk Gumus Zafer Ergul Oskay Kaya Serdar Altun R Erkin Unlu Hakan Orbay Deog-Im Kim Seung-Ho Han Yi-Suk Kim Ho-Jeong Kim Kyu-Seok Lee Omur Elcioglu Hilmi Ozden Gul Guven Nurcan Imre Bulent Yalcin Hasan Ozan Pinar Akyer Mustafa Guvencer Vasfi Karatosun Mandeep Gill Sagoo Rachel Claire Aland Derya Ustuner M Cengiz Ustuner Jafar Ai Seyed Reza Ghazi Seyed Hadi Mansouri Mehmet Cudi Tuncer Mehmet Ufuk Aluclu Ozlen Karabulut Eyup Savas Hatipoglu Hasan Nazaroglu Cigdem Icke Emrah Akbay Turkan Gunay Suleyman Icke Selda Yildiz Fatih Yazar Barcin Orhan Barlas Delia Elena Zahoi Ahmet Kavakli Ufuk Tas Durrin Ozlem Dabak Hilal Irmak Sapmaz Necdet Kocabiyik Ce Department of Anatomy Dokuz Eylul University Izmir Turkey. funda.tastekin@deu.edu.tr. Department of Emergency Medicine Dokuz Eylul University Izmir Turkey. Department of Anatomy Dokuz Eylul University Izmir Turkey. Department of Anatomy Dokuz Eylul University Medical Faculty Izmir Turkey. Department of Histology and Embryology Mustafa Kemal University Faculty of Medicine Antakya-Hatay Turkey. Department of Anatomy Institute of Anatomy Sarajevo Bosnia and Herzegovina. Department of Anatomy The University of Sarajevo Medical Faculty Sarajevo Bosnia and Herzegovina. Department of Histology and Embriology Institute of Histology and Embriology Sarajevo Bosnia and Herzegovina. Department of Clinical Pathology Institute of Clinical Pathology Sarajevo Bosnia and Herzegovina. Department of Anatomy Kocaeli University Kocaeli Turkey. Department of Anatomy Kocaeli University Medical Faculty Kocaeli Turkey. Department of Neurology Kocaeli University Kocaeli Turkey. Department of Physical Education and Sport Kocaeli University Kocaeli Turkey. Department of Anatomy Gulhane Military Medical Academy Ankara Turkey. Department of Anatomy Faculty of Medicine Gulhane Military Medical Academy Ankara Turkey. Department of Anatomy Gulhane Military Medical Academy Faculty of Medicine Ankara Turkey. Department of Oral Diagnosis and Radiology Faculty of Dentistry Ankara University Ankara Turkey. Department of Oral Diagnosis and Radiology Ankara University Faculty of Dentistry Ankara Turkey. Department of Oral Diagnosis and Radiology Gulhane Military Medical Academy Ankara Turkey. Department of Oral Diagnosis and Radiology Gulhane Military Medical Academy Dental Science Center Ankara Turkey. Department of Anatomy Dicle University Diyarbakir Turkey. Department of Anatomy Dicle University Medical Faculty Diyarbakir Turkey. Department of Histology-Embriyology Faculty of Medicine Gulhane Military Medical Academy Ankara Turkey. Department of Anatomy Inonu University Sch

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A non-traumatic interhemispheric subdural haematoma: Presented with headache as the sole complaint

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Journal of Headache and Pain 2005年第1期6卷 48-50页

作者： Alemdar, Murat selekler, Hamit macit Efendi, Husnu Department of Neurology Faculty of Medicine University of Kocaeli Derince 41900 Kocaeli Turkey

Due to their localisations and symptoms, interhemispheric subdural haematomas (ISH) compose a distinct category. Altered level of consciousness and hemiparesis are the most frequent symptoms. We report a case of ISH who presented with headache as the sole complaint. Left cerebellar haematoma and ISH were found incranial MRI and cranial computed tomography Cranial MR angiogram was normal. Haemogram and coagulation parameters were within normal limits. ISH should be considered among the diagnostic possibilities in elderly patients who present with headache as the sole symptom without other clinical features such as meningeal irritation signs, focal neurological symptoms and alteration of consciousness. Cranial imaging studies should be done in such cases. © Springer-Verlag Italia 2005.

关键词： Interhemispheric subdural haematoma Secondary headache

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Isolated Abducens Nerve Palsy Associated with Retinoic Acid Therapy: A Case Report

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STRABISMUS 2005年第3期13卷 129-132页

作者： Alemdar, Murat Iseri, Pervin selekler, Hamit macit Serbest, Alev Selek Komsuoglu, Sezer Sener Kocaeli Univ Fac Med Dept Neurol Izmit Kocaeli Turkey Kocaeli Univ Fac Med Dept Int Med Izmit Kocaeli Turkey

Isolated abducens nerve palsy is a rare complication of treatment with various drugs. Here, the authors report the case of a 23-year-old female with isolated left abducens nerve palsy after long-term retinoic acid therapy. The association is based on the temporal relationship and the exclusion of other possible etiologic factors following extensive laboratory and imaging diagnostics. The authors suggest that isolated abducens nerve palsy may be a presenting sign of a toxic neuropathy associated with retinoic acid therapy. After the exclusion of other organic lesions, especially idiopathic intracranial hypertension, and an assessment of the risk-benefit ratio, discontinuation of treatment must be considered in such cases.

关键词： Abducens nerve palsy cranial nerve paresis retinoic acid adverse drug reactions

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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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Patients' postures during migraine attacks

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Journal of Headache and Pain 2003年第2期4卷 83-87页

作者： selekler, H. macit Can, Hafize Budak, Faik Department of Neurology Faculty of Medicine Kocaeli University Kocaeli Turkey

The aim of this study was to determine postures adopted by patients during migraine attack. A total of 199 migraine patients were questioned about their postures during the migraine attack. Of these, 92 patients did not choose a specific lying position, 22 could not lie down during the attack because of the increase in pain, while 6 avoided lying due to scalp tenderness. During the attack, 19 patients preferred holding their heads up (compared to painless period) with a few pillows and 41 applied pressure on the aching side;15 lay with their necks extended and 15 lay face downward. Various combinations of these postures were also reported. Pain may arise from extracranial muscles as well as vessels during a migraine attack. The posture chosen during attack is a reflection of vascular and muscle pains that provoke symptoms. The postures that patients chose were aimed to lessen the severity of symptoms of their migraine attacks. Patients know the position they adopt and do not need to be told by a doctor, but they come to consultations to be understood, to learn that others behave in the same way, and in some, to obtain reasons for their posture. The existence of a specific lying posture can be an advantage for the physician in terms of approaching the patient and selecting an appropriate therapy.

关键词： Attack Migraine Posture

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