Browsing by Author "Erdoğan M."
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Item Gastrostomy in Hospitalized Patients with Acute Stroke: “NöroTek” Turkey Point Prevalence Study Subgroup Analysis; [Hastanede Yatan Akut İnmeli Hastalarda Gastrostomi: “NöroTek” Türkiye Nokta Prevalans Çalışması Alt Grup Analizi](Turkish Neurosurgical Society, 2022) Topçuoğlu M.A.; Özdemir A.Ö.; Aykaç Ö.; Milanoğlu A.; Gökçe M.; Bavli S.; Çabalar M.; Yayla V.; Erdoğan H.A.; Özkul A.; Güneş A.; Değirmenci B.; Aluçlu U.; Kozak H.H.; Güngör L.; Erdoğan M.; Acar Z.Ö.; Cenikli U.; Kablan Y.; Yılmaz A.; Genç H.; Nazliel B.; Çağlayan H.B.; Gencer E.S.; Ay H.; Demirbaş H.; Akdoğan Ö.; Emre U.; Yıldız Ö.K.; Bolayır A.; Demir T.; Tanrıverdi Z.; Tekan Ü.Y.; Akpınar Ç.K.; Özkan E.; İlik F.; Şirin H.; Güler A.; Önder H.; Bektaş H.; Öcek L.; Bakar M.; Ongun N.; Krespi Y.; Işıkay C.T.; Aslanbaba E.; Sorgun M.; Gürkaş E.; Karadeli H.H.; Midi İ.; İlgezdi İ.; Bilgiç A.B.; Akyol Ş.; Epçeliden M.T.; Atmaca M.M.; Kurşun O.; Keskin O.; Şirinocak P.B.; Baydemir R.; Akçakoyunlu M.; Öztürk Ş.; Özel T.; Ünal A.; Dora B.; Yürekli V.A.; Arlıer Z.; Eren A.; Yılmaz A.; Kısabay A.; Acar B.; Baştan B.; Niflioğlu B.; Güven B.; Kaya D.; Afşar N.; Yazıcı D.; Aytaç E.; Yaka E.; Toplutaş E.; Değirmenci E.; İnce F.B.; Büyükşerbetçi G.; Aydın İ.; Çetiner M.; Şen M.; Turgut N.; Kale N.; Çoban E.; Yeşilot N.; Ekizoğlu E.; Kizek Ö.; Birgili Ö.; Yevgi R.; Kunt R.; Giray S.; Akkaş S.Y.; Şenadım S.; Yoldaş T.; Asil T.; Duman T.; Atasoy T.; Çınar B.P.; Demir T.; Can U.; Ünsal Y.Ö.; Eşkut N.; Aslan Y.; Baş D.F.; Şener U.; Yılmaz Z.; Bozdoğan Z.; Alioğlu Z.; Arsava E.M.Objective: Nutritional status assessment, dysphagia evaluation and enteral feeding decision are important determinants of prognosis in acute neurovascular diseases. Materials and Methods: NöroTek is a point prevalence study conducted with the participation of 87 hospitals spread across all health sub regions of Turkey conducted on 10-May-2018 (World Stroke Awareness Day). A total of 972 hospitalized neurovascular patients [female: 53%, age: 69±14; acute ischemic stroke in 845; intracerebral hematoma (ICH) in 119 and post-resuscitation encephalopathy (PRE) in 8] with complete data were included in this sub-study. Results: Gastrostomy was inserted in 10.7% of the patients with ischemic stroke, 10.1% of the patients with ICH and in 50% of the patients with PRE. Independent predictors of percutaneous endoscopic gastrostomy (PEG) administration were The National Institutes of Health Stroke Scale score at admission [exp (β): 1.09 95% confidence interval (CI): 1.05-1.14, per point] in ischemic stroke; and mechanical ventilation in ischemic [exp (β): 6.18 (95% CI: 3.16-12.09)] and hemorrhagic strokes [exp (β): 26.48 (95% CI: 1.36-515.8)]. PEG was found to be a significant negative indicator of favorable (modified Rankin’s scale score 0-2) functional outcome [exp (β): 0.032 (95% CI: 0.004-0.251)] but not of in-hospital mortality [exp (β): 1.731 (95% CI: 0.785-3.829)]. Nutritional and swallowing assessments were performed in approximately two-thirds of patients. Of the nutritional assessments 69% and 76% of dysphagia assessments were completed within the first 2 days. Tube feeding was performed in 39% of the patients. In 83.5% of them, tube was inserted in the first 2 days; 28% of the patients with feeding tube had PEG later. Conclusion: The NöroTek study provided the first reliable and large-scale data on key quality metrics of nutrition practice in acute stroke in Turkey. In terms of being economical and accurate it makes sense to use the point prevalence method. © 2022 by Turkish Neurological Society.Item Acute Stroke Management in Türkiye: Intravenous Tissue Plasminogen Activator and Thrombectomy NöroTek: Türkiye Neurology Single Day Study; [Türkiye’de Akut İnme Yönetimi: IV tPA ve Trombektomi NöroTek: Türkiye Nöroloji Tek Gün Çalışması](Turkish Neurosurgical Society, 2023) Topçuoğlu M.A.; Özdemir A.Ö.; Arsava E.M.; Güneş A.; Aykaç Ö.; Gencer E.S.; Çabalar M.; Yayla V.; Erdoğan H.A.; Erdoğan M.; Acar Z.Ö.; Giray S.; Kablan Y.; Tanrıverdi Z.; Tekan Ü.Y.; Asil T.; Akpınar Ç.K.; Yürekli V.A.; Acar B.; Şirin H.; Güler A.; Baydemir R.; Akçakoyunlu M.; Öcek L.; Çetiner M.; Nazlıel B.; Çağlayan H.B.; Ongun N.; Eren A.; Arlıer Z.; Cenikli U.; Gökçe M.; Bavli S.; Yaka E.; Özkul A.; Değirmenci B.; Aluçlu U.; Işıkay C.T.; Aslanbaba E.; Sorgun M.; Aytaç E.; Ay H.; Kunt R.; Şenadım S.; Ünsal Y.Ö.; Eşkut N.; Alioğlu Z.; Yılmaz A.; Genç H.; Yılmaz A.; Milanoğlu A.; Gürkaş E.; Değirmenci E.; Bektaş H.; İlgezdi İ.; Bilgiç A.B.; Akyol Ş.; Güngör L.; Kale N.; Çoban E.; Yeşilot N.; Ekizoğlu E.; Kizek Ö.; Kurşun O.; Yıldız Ö.K.; Bolayır A.; Kısabay A.; Baştan B.; Niflioğlu B.; Güven B.; Kaya D.; Afşar N.; Yazıcı D.; Toplutaş E.; Özkan E.; İlik F.; İnce F.B.; Büyükşerbetçi G.; Önder H.; Karadeli H.H.; Kozak H.H.; Demirbaş H.; Midi İ.; Aydın İ.; Epçeliden M.T.; Atmaca M.M.; Bakar M.; Şen M.; Turgut N.; Keskin O.; Akdoğan Ö.; Emre U.; Bilgili Ö.; Şirinocak P.B.; Yevgi R.; Akkaş S.Y.; Yoldaş T.; Duman T.; Özel T.; Ünal A.; Dora B.; Atasoy T.; Çınar B.P.; Demir T.; Demir T.; Can U.; Aslan Y.; Baş D.F.; Şener U.; Yılmaz Z.; Bozdoğan Z.; Özdemir G.; Krespi Y.; Öztürk Ş.Objective: To reveal the profile and practice in patients with acute stroke who received intravenous tissue plasminogen activator (IV tPA) and/or neuro-interventional therapy in Türkiye. Materials and Methods: On World Stroke Awareness Day, May 10, 2018, 1,790 patients hospitalized in 87 neurology units spread over 30 health regions were evaluated retrospectively and prospectively. Results: Intravenous tPA was administered to 12% of 859 cases of acute ischemic stroke in 45 units participating in the study. In the same period, 8.3% of the cases received neurointerventional treatment. The rate of good prognosis [modified Rankin score (mRS) 0–2] at discharge was 46% in 83 patients who received only IV tPA [age: 67 ± 12 years; National Institutes of Health Stroke Scale (NIHSS): 12 ± 6; hospital stay, 24 ± 29 days]; 35% in 51 patients who underwent thrombectomy (MT) alone (age: 64 ± 13 years; NIHSS: 14.1 ± 6.5; length of hospital stay, 33 ± 31 days), 19% in those who received combined treatment (age: 66 ± 14 years; NIHSS: 15.6 ± 5.4; length of hospital stay, 26 ± 35 days), and 56% of 695 patients who did not receive treatment for revascularization (age: 70 ± 13 years; NIHSS: 7.6 ± 7.2; length of hospital stay, 21 ± 28 days). The symptom-to-door time was 87 ± 53 minutes in the IV treatment group and 200 ± 26 minutes in the neurointerventional group. The average door-to-needle time was 66 ± 49 minutes in the IV tPA group. In the neurothrombectomy group, the door-to-groin time was 103 ± 90 minutes, and the TICI 2b-3 rate was 70.3%. In 103 patients who received IV tPA, the discharge mRS 0–2 was 41%, while the rate of mRS 0–1 was 28%. In 71 patients who underwent neurothrombectomy, the mRS 0–2 was 31% and mRS 0–1 was 18%. The door-to-groin time was approximately 30 minutes longer if IV tPA was received (125 ± 107 and 95 ± 83 minutes, respectively). Symptomatic bleeding rates were 4.8% in IV recipients, 17.6% among those who received only MT, and 15% in combined therapy. Globally, the hemorrhage rate was 6.8% in patients receiving IV tPA and 16.9% in MT. Conclusion: IV thrombolytic and neurointerventional treatment applications in acute ischemic stroke in Türkiye can provide the anticipated results. Heterogeneity has begun to be reduced in our country with the dissemination of the system indicated by the “Directive on Health Services to be Provided to Patients with Acute Stroke.”. © Copyright 2023 by the Turkish Neurological Society / Turkish Journal of Neurology published by Galenos Publishing House.Item Atrial Fibrillation Management in Acute Stroke Patients in Türkiye: Real-life Data from the NöroTek Study; [Türkiye’de İnme Hastalarında Atrial Fibrilasyonun Yönetimi: NöroTek Çalışması Gerçek Hayat Verileri](Turkish Neurosurgical Society, 2023) Topçuoğlu M.A.; Arsava E.M.; Özdemir A.Ö.; Aykaç Ö.; Çetiner M.; Gencer E.S.; Güneş A.; Krespi Y.; Yaka E.; Öcek L.; Tanrıverdi Z.; Tekan Ü.Y.; Özkul A.; Özkan E.; Şirin H.; Güler A.; Kurşun O.; Kunt R.; Cenikli U.; Acar B.; Kablan Y.; Yılmaz A.; Işıkay C.T.; Aslanbaba E.; Sorgun M.; Bektaş H.; Çabalar M.; Yayla V.; Erdoğan H.A.; Gökçe M.; Bavli S.; Ongun N.; Keskin A.O.; Akdoğan Ö.; Emre U.; Yıldız Ö.K.; Bolayır A.; Akpınar Ç.K.; Karadeli H.H.; Özel T.; Ünal A.; Dora B.; Arlıer Z.; Eren A.; Milanoğlu A.; Nazliel B.; Çağlayan H.B.; Güven B.; Erdoğan M.; Acar Z.Ö.; Bakar M.; Giray S.; Şenadım S.; Asil T.; Demir T.; Ünsal Y.Ö.; Eşkut N.; Aslan Y.; Baş D.F.; Şener U.; Değirmenci B.; Aluçlu U.; Baştan B.; Niflioğlu B.; Yazıcı D.; Aytaç E.; İnce F.B.; Ay H.; Önder H.; Kozak H.H.; İlgezdi İ.; Bilgiç A.B.; Akyol Ş.; Güngör İ.L.; Atmaca M.M.; Şen M.; Yevgi R.; Akkaş S.Y.; Yoldaş T.; Atasoy H.T.; Çınar B.P.; Yılmaz A.; Genç H.; Kısabay A.; İlik F.; Demirbaş H.; Midi İ.; Şirinocak P.B.; Duman T.; Demir T.; Can U.; Yürekli V.A.; Bozdoğan Z.; Alioğlu Z.; Kaya D.; Afşar N.; Gürkaş E.; Toplutaş E.; Değirmenci E.; Büyükşerbetçi G.; Aydın İ.; Epçeliden M.T.; Turgut N.; Kale N.; Çoban E.; Yeşilot N.; Ekizoğlu E.; Kizek Ö.; Bilgili Ö.; Baydemir R.; Akçakoyunlu M.; Yılmaz Z.; Öztürk Ş.Objective: Atrial fibrillation (AF) is the most common directly preventable cause of ischemic stroke. There is no dependable neurology-based data on the spectrum of stroke caused by AF in Türkiye. Within the scope of NöroTek-Türkiye (TR), hospital-based data on acute stroke patients with AF were collected to contribute to the creation of acute-stroke algorithms. Materials and Methods: On May 10, 2018 (World Stroke Awareness Day), 1,790 patients hospitalized at 87 neurology units in 30 health regions were prospectively evaluated. A total of 929 patients [859 acute ischemic stroke, 70 transient ischemic attack (TIA)] from this study were included in this analysis. Results: The rate of AF in patients hospitalized for ischemic stroke/TIA was 29.8%, of which 65% were known before stroke, 5% were paroxysmal, and 30% were diagnosed after hospital admission. The proportion of patients with AF who received “effective” treatment [international normalization ratio ≥2.0 warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) at a guideline dose] was 25.3%, and, either no medication or only antiplatelet was used in 42.5% of the cases. The low dose rate was 50% in 42 patients who had a stroke while taking NOACs. Anticoagulant was prescribed to the patient at discharge at a rate of 94.6%; low molecular weight or unfractionated heparin was prescribed in 28.1%, warfarin in 32.5%, and NOACs in 31%. The dose was in the low category in 22% of the cases discharged with NOACs, and half of the cases, who received NOACs at admission, were discharged with the same drug. Conclusion: NöroTekTR revealed the high but expected frequency of AF in acute stroke in Türkiye, as well as the aspects that could be improved in the management of secondary prophylaxis. AF is found in approximately one-third of hospitalized acute stroke cases in Türkiye. Effective anticoagulant therapy was not used in three-quarters of acute stroke cases with known AF. In AF, heparin, warfarin, and NOACs are planned at a similar frequency (one-third) within the scope of stroke secondary prophylaxis, and the prescribed NOAC dose is subtherapeutic in a quarter of the cases. Non-medical and medical education appears necessary to prevent stroke caused by AF. © 2023 by the Turkish Neurological Society / Turkish Journal of Neurology published by Galenos Publishing House.Item Pulsatile Proptosis and Sphenoid Wing Dysplasia with no Evidence of Neurofibromatosis Type 1: A Case Report and Review of the Literature(Turkish Ophthalmology Society, 2024) Delibay Akgün Y.; Erdoğan M.; Altınışık M.; Mayalı H.; İlker S.S.In this study, we aimed to present a rare case of pulsatile proptosis due to sphenoid wing dysplasia without the features of neurofibromatosis type 1 (NF1). A 17-year-old male patient presented with swelling in the superotemporal region of the right eye. Physical examination revealed facial asymmetry with a pulsatile, ill-defined, soft lesion with in the superotemporal region of the right orbit associated with pulsatile proptosis, downward dystopia, and hypotropia. Computer tomography imaging to establish a differential diagnosis showed temporal lobe herniation secondary to sphenoid wing dysplasia. The patient was assessed for NF1, which is most commonly associated with sphenoid wing dysplasia, but no evidence supporting the diagnosis was found. Patients presenting with proptosis should be carefully examined for pulsation and murmurs, and a trauma history should be investigated. Radiological imaging should be used to facilitate the differential diagnosis, and the current clinical condition should be managed with a multidisciplinary approach. © 2024 by the Turkish Ophthalmological Association / Turkish Journal of Ophthalmology published by Galenos Publishing House.