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Öğe Clinical and Demographic Characteristics and Two-Year Efficacy and Safety Data of 508 Multiple Sclerosis Patients with Fingolimod Treatment(Turkish Neuropsychiatry Assoc-Türk Noropsikiyatri Derneği, 2023) Terzi, Murat; Helvacı, Elif Merve; Şen, Sedat; Boz, Cavit; Çam, MustafaIntroduction: Fingolimod is the first oral immunomodulatory treatment used as secondary care therapy in the treatment of multiple sclerosis for the last 10 years. The objective of our study is to reveal the experiences of the first generic fingolimod active ingredient treatment in different centers across Turkey. Method: The first generic fingolimod efficacy and safety data of patients followed-up in 29 different clinical multiple sclerosis units in Turkey were analyzed retrospectively. Data regarding efficacy and safety of the patients were transferred to the data system both before the treatment and on the 6th, 12th and 24th month following the treatment. The data were analyzed using the IBM SPSS 20.00. P value of <0.05 was considered to be statistically significant. Results: A total of 508 multiple sclerosis patients, 331 of whom were women, were included in the study. Upon comparing the Expanded Disability Status values before and after the treatment, a significant decrease was observed, especially at month 6 and thereafter. Since bradycardia occurred in 11 of the patients (2.3%), the first dose had to be longer than 6 hours. During the observation of the first dose, no issues that could prevent the use of the drug occured. Side effects were seen in 49 (10.3%) patients during the course of fingolimod treatment. Respectively, the most frequent side effects were bradycardia, hypotension, headache, dizziness and tachycardia. Conclusion: The observed results regarding efficacy and safety were similar to clinical trial data in the literature and real life data in terms of the first equivalent with fingolimod active ingredient.Öğe Clinical, Demographic, and Radiological Characteristics of Patients Demonstrating Antibodies Against Myelin Oligodendrocyte Glycoprotein(Trakya University School of Medicine , 2024) Koç, Sümeyye; Şen, Sedat; Terzi, Yüksel; Kızılay, Ferah; Demir, Serkan; Bekar Aksoy, Dürdane; Kurtuluş, Fatma; Çam, MustafaBackground: Optic neuritis, myelitis, and neuromyelitis optica spectrum disorder (NMOSD) have been associated with antibodies against myelin oligodendrocyte glycoprotein-immunoglobulin G (anti-MOG-IgG). Furthermore, patients with radiological and demographic features atypical for multiple sclerosis (MS) with optic neuritis and myelitis also demonstrate antibodies against aquaporin-4 and anti-MOG-IgG. However, data on the diagnosis, treatment, follow-up, and prognosis in patients with anti-MOG-IgG are limited. Aims: To evaluate the clinical, radiological, and demographic characteristics of patients with anti-MOG-IgG. Study Design: Multicenter, retrospective, observational study. Methods: Patients with blood samples demonstrating anti-MOG-IgG that had been evaluated at the Neuroimmunology laboratory at Ondokuz Mayıs University's Faculty of Medicine were included in the study. Results: Of the 104 patients with anti-MOG-IgG, 56.7% were women and 43.3% were men. Approximately 2.4% of the patients were diagnosed with MS, 15.8% with acute disseminated encephalomyelitis (ADEM), 39.4% with NMOSD, 31.3% with isolated optic neuritis, and 11.1% with isolated myelitis. Approximately 53.1% of patients with spinal involvement at clinical onset demonstrated a clinical course of NMOSD. Thereafter, 8.8% of these patients demonstrated a clinical course similar to MS and ADEM, and 28.1% demonstrated a clinical course of isolated myelitis. The response to acute attack treatment was lower and the disability was higher in patients aged > 40 years than patients aged < 40 years at clinical onset. Oligoclonal band was detected in 15.5% of the patients. Conclusion: For patients with NMOSD and without anti-NMO antibodies, the diagnosis is supported by the presence of anti-MOG-IgG. Furthermore, advanced age at clinical onset, Expanded Disability Status Scale (EDSS) score at clinical onset, spinal cord involvement, and number of attacks may be negative prognostic factors in patients with anti-MOG-IgG.Öğe Correction to: Clinical and demographic characteristics and two-year efficacy and safety data of 508 multiple sclerosis patients with fingolimod treatment (Archives of Neuropysychiatry, 60, 23)(Turkish Neuropsychiatry Assoc-Türk Noropsikiyatri Derneği, 2023) Terzi, Murat; Helvacı, Elif Merve; Sen, Sedat; Boz, Cavit; Çilingir, Vedat; Akçalı, Aylin; Beckmann, Yeşim; Çam, Mustafa[Anstract Not Available]Öğe Corrigendum to “The role of oligoclonal band count and IgG index in treatment response and disease activity in multiple sclerosis” [Multiple Sclerosis and Related Disorders 83 (2024) 105391](Elsevier Sci Ltd, 2025) Taşkıran, Esra; Terzi, Murat; Helvacı, Elif Merve; Eser, Meltem Zeycan; Avcı, Bahattin; Faruk, Turan Ömer; Yetkin, Mehmet Fatih; Çam, Mustafa[No abstract available]Öğe Could tear endothelin-1 levels be associated with disability in multiple sclerosis?(Asean Neurological Assoc, 2023) Çam, Mustafa; Şehitoğlu, HilalBackground: Endothelin-1 (ET-1) is a potent vasoconstrictor substance mainly secreted by endothelial cells. Increased ET-1 levels in plasma or cerebrospinal fluid (CSF) have been identified in multiple sclerosis (MS). We aimed to analyze tear ET-1 levels; visual evoked potential (VEP) and disability scores in patients with MS and in healthy controls. Methods: Adult patients (18-65 year-old) diagnosed with MS according to the McDonald criteria, and healthy controls were recruited for the study. Demographic features, VEP, and tear ET-1 levels were evaluated. Disability in the MS group was assessed and grouped by EDSS score (<3 vs. >= 3). The EDSS score in healthy controls was zero. Results: Both in the total number of patients overall and in the patients with EDSS score <3, tear ET-1 levels were higher in the MS group than that in the controls (p<0.001). In the MS group, the ET-1 level was higher in the patients with EDSS score >= 3 than in those with EDSS score <3 (p<0.001). The tear ET-1 level was positively correlated with age and EDSS score in the MS group (p<0.001). Conclusion: To the best of our knowledge, there is no study in the literature that measures tear ET-1 levels in MS and examines their relationship with EDSS score and VEP. Higher tear ET-1 levels seem to be associated with disability and abnormal VEP in MS. Tear ET-1 measurement may be a simple new noninvasive marker indicating the disability in the patients with MS in the future.Öğe Evaluation of knowledge and awareness levels of drugs used in smoking cessation treatment(Pamukkale University, 2022) Çam, Mustafa; Akşit, ErcanPurpose: Smoking is among the modifiable risk factors for cardiovascular diseases and stroke. In the followups after quitting this habit, it has been shown that there is a decrease in the mortality rate related to the cardiovascular system and an increase in the quality of life of the patients. In this study, it was aimed to investigate the awareness of the drugs used in smoking cessation on patients and healthy individuals. Materials and methods: Our study was planned as cross-sectional. Patients who applied with any complaints and 198 volunteers from healthcare professionals working in the hospital were included. With the questions in the questionnaire, it was aimed to learn the awareness levels about the drugs used in smoking cessation. Results: In our study, it was determined that women and other professionals did not have statistically significant information in the question in which the effects of these drugs on pulse and blood pressure levels were evaluated. The statement that individuals in other occupational groups did not know about the effect of bupropion treatment on this system was found to be statistically significantly higher (p<0.01). Conclusion: In our study, participants' awareness of smoking cessation treatments was found to be low. Knowing these treatments and being able to prescribe these drugs safely if their patients are stable will have a very important place in the fight against smoking. © 2022, Pamukkale University. All rights reserved.Öğe Intravenous thrombolytic treatment of a patient who had a stroke after COVID-19 Thrombolytic treatment and stroke after COVID-19(Bayrakol Medical Publishing, 2021) Çam, Mustafa; Ocak, ÖzgülThe infection, reported by the WHO as COVID-19, may occur with asymptomatic or mild symptoms, resulting in shock and even death. Stroke occupies an important place among the neurological complications of this disease. In the acute period, intravenous (IV) alteplase therapy is useful in patients suitable for the treatment.This case report includes a 70-year-old patient with mild COVID findings, who had an early complication of stroke and who received a nearly complete benefit from thrombolytic therapy.Stroke can occur in COVID patients at an early stage of the disease. IV thrombolytic therapy should be administered in appropriate patients during the period of acute stroke. As far as we know, the earliest application in our country was carried out in our hospital and was quite successful. After the treatment, the symptoms of COVID-19 also regressed and he was discharged on the 5th day of his hospitalization.Öğe Investigation of patients with temporal lobe epilepsy using quantitative electroencephalography and magnetic resonance spectroscopy(Bayrakol Medical Publishing, 2021) Çam, Mustafa; Kıroğlu, Yılmaz; Değirmenci, EylemAim: Temporal lobe epilepsy (TLE) is the most common focal epilepsy in adulthood. Magnetic resonance spectroscopy (MRS) is an MRI technique used to mea-sure regional variations in neurochemistry and display the concentrations of various brain metabolites in preset regions of interest in the brain. In this study, we aimed to evaluate the correlation of qEEG abnormalities and MRS findings in patients with temporal lobe epilepsy (TLE). Material and Methods: Power spectrum analyses of each multi-channel EEG were performed in all patients with the concomitant MRS measures of Choline (Cho), total Creatine (Cr), N-acetyl aspartate (Naa) concentrations, and ratios of Cho/Cr, Naa/Cr, and Naa/Cho.Results: Mean qEEG band powers of anterior alfa, anterior beta, central alfa, central beta, posterior alfa, and posterior beta in the right temporal area was significantly larger in patients whose Naa/Cho+Cr ratio was lower than 0.71 compared to patients whose Naa/Cho+Cr ratio was equal and larger than 0.71. In addition, correlation analyses between Naa/Cho+Cr, Naa/Cho+Cr, and Naa/Cho ratios and qEEG band power values showed low-medium correlations.Discussion: A relationship detected between the biochemical changes of the epileptogenic focus due to neuronal dysfunction and the QEEG data may help prove the presence of the focal point.Öğe Investigation of the frequency and relationship of fragmented QRS in patients with ischemic stroke Fragmented QRS in patients with ischemic stroke(Bayrakol Medical Publishing, 2021) Çam, Mustafa; Malçok, Ümit Ali; Akşit, Ercan; Ocak, ÖzgülAim: Acute ischemic stroke is an important cause of morbidity and mortality. Fragmented QRS (fQRS) is a depolarization disorder, which may be easily detected in 12-lead superficial electrocardiography (ECG), which displays a conduction delay caused by myocardial fibrotic tissue. Although the association of fQRS with ischemic heart disease is well known, there is no clear information about its relationship with ischemic stroke. In the present study, we aimed to investigate the relationship between fQRS and ischemic stroke.Material and Methods: Seventy consecutive patients with a diagnosis of ischemic stroke and 48 healthy individuals were included in this cross-sectional study. Baseline demographic and echocardiographic characteristics were recorded, and surface 12-lead standard ECGs were used.Results: The mean age of the patients was 65.19±13.91 years, and 46.6% were male. The number of patients with fQRS in the ischemic stroke group was greater than in the control group (p = 0.009). In multiple logistic regression analysis, left ventricular end-systolic diameter (LVESD) (p = 0.013, Odds ratio (OR) = 4.284, 95% Confidence interval (C.I.) = 1.366–13.432), and left atrium diameter (p = 0.020, OR = 3.985, 95% C.I. = 1.240–12.803) were found to be independent predictors of ischemic stroke.Discussion: The current study was the first to focus on evaluating the relationship between fQRS and ischemic stroke. In light of these results, we can say that patients with fQRS, who had lower LVEF, greater LVESD, and larger left atrium represent a high-risk group for ischemic stroke. fQRS may be utilized in a follow-up of these patients and in any consideration of early anticoagulation treatmentÖğe Küçük ve Orta Büyüklükteki İşletmelerin Basel II Kriterlerine Uyum Durumlarını Tespit Etmeye Yönelik Bir Araştırma(Çanakkale Onsekiz Mart Üniversitesi, 2009) Uluyol, Osman; Çam, MustafaBu makalede Türkiye’de 2009 yılında uygulanmaya başlaması amaçlanan Basel II kriterlerine karşı Türk işletmelerinin ne düzeyde hazırlıklı oldukları ve bu sürece uyum sağlamak için ne tür hazırlık çalışmaları yaptıkları araştırılmaktadır. Öncelikle Basel II hakkında teorik bilgi verilmekte ve Basel II kriterlerinin Türkiye’de uygulamaya başlanmasıyla birlikte bu sürecin Türk KOBİ’leri üzerindeki olası etkilerinin neler olacağı hakkında bazı tespitler yapılmakta ve mevcut durumun araştırılması amacıyla KOBİ’ler üzerinde yapılan bir anket uygulamasının sonuçlarına yer verilmektedir. Çalışmanın sonunda anket sonuçlarına göre yapılan bir değerlendirme ve çözüm önerileri yer almaktadır.Öğe RELATION BETWEEN SPONTANEOUS INTRACEREBRAL HEMORRHAGE AND fQRS COMPLEX(Merthan TUNAY, 2021) Malçok, Ümit Ali; Çam, Mustafa; Akşit, Ercan; Ocak, ÖzgülIntroduction: There has not been a change in spontaneous intracerebral hemorrhage (SICH) incidence over the last three decades. Mean age of cases keep rising. Despite the rising success rate of treatments, there has not been a significant improvement in prediction of hemorrhages beforehand. In this study, we aimed to find whether there was a relation between fragmented QRS (fQRS) complex and SICH in follow-up of risky patients.Materials and Methods: This study was planned as a case-control study. The data of 30 SISH and 30 healthy control individuals who meet the criteria were used in the study. Those who scored between 1-5 points according to the hemorrhage severity scale were discarded and the cases who scored zero points were included in the study. Interpretation of electrocardiogram (ECG) records and echocardiogram (ECHO) procedures were performed blindly by a cardiologist. The existence of fQRS complex in ECG records and standard parameters in ECHO procedure were evaluated.Results: Mean age of hemorrhage cases was 69 and 19 of them (%63) were male. There were not any significant differences in age, diabetes prevalance and smoking habits between groups, however, hypertension (HT) was seen more frequently in hemorrhage cases (p<0.05). fQRS complexes were seen more frequently in SICH group compared to the control group (p<0.01). In addition to the decrease in left ventricular ejection fraction (LVEF) (p<0.05), there was also an increase in left atrium (LA) (p<0.05). However, it was observed that SISH cases with fQRS complex in ECG recordings were 5 times more than the control group (OR 5.2, p<0.01).Conclusion: In this study, the relation between the existence of fQRS and SICH risk was evaluated. The fQRS complex in his ECG; It was concluded that in patients with a decrease in LVEF, an increase in LA and accompanying HT, SISH is seen moreÖğe SPONTAN İNTRASEREBRAL HEMORAJİ İLE fQRS KOMPLEKSİ ARASINDAKİ İLİŞKİ(2021) Malçok, Ümit Ali; Çam, Mustafa; Aksit, Ercan; Ocak, ÖzgülAmaç: Spontan intraserebral hemoraji (SİSH) insidansında, son üç dekat boyunca değişim olmadığı ve olguların yaş ortalamalarının arttığı görülmektedir. Günümüzde, hastaların tedavilerindeki başarı oranı artmakta ancak kanamaların tahmin edilmesinde umut verici bir ilerleme sağlanamamıştır. Bu çalışmada, fragmente QRS (fQRS) kompleks varlığı ile SİSH arasında bir ilişki olup olmadığını göstermeyi amaçladık. Materyal ve Metot: Bu çalışma vaka-kontrol çalışması olarak planlanmıştır. Çalışma kriterlere uygun 30 SİSH’li ve 30 sağlıklı kontrol bireye ait veriler kullanıldı. Hemoraji derecelendirme ölçeğine göre 1-5 puan alanlar çalışma dışı bırakıldı ve sıfır puan alan olgular çalışmaya alındı. Tüm olgulara ait elektrokardiyogram (EKG) kayıtlarının yorumlanması ve ekokardiyografi (EKO) işlemleri, kardiyoloji uzmanı tarafından kör olarak gerçekleştirildi ve EKG kayıtlarında fQRS kompleksi varlığı arandı. Bulgular: Hemoraji geçiren hastaların yaş ortalaması 69 ve 19’u (%63) erkekti. Grupların yaşları, diyabet prevalansı ve sigara alışkanlıkları arasında belirgin bir fark yoktu, ancak hipertansiyonun (HT) kanama geçiren olgularda daha fazla bulunduğu görüldü (p<0,05). Ayrıca SİSH hastalarında, kontrol grubuna kıyasla fQRS kompleksi daha sık görüldü (p<0,01). SİSH olgularına ait EKO parametrelerinde ise sol ventrikül ejeksiyon farksiyonunda (SVEF) azalmanın (p<0,05) yanı sıra sol atriyumda (SA) artış olduğu görüldü (p<0,05). Bununla birlikte, EKG kayıtlarında fQRS kompleksi bulunan SİSH olgularının, kontrol grubuna göre 5 kat daha fazla olduğu görüldü (OR 5,2, p<0,01). Sonuç: Bu çalışmada fQRS varlığı ile SİSH arasındaki ilişki değerlendirildi. EKG’sinde fQRS kompleksi bulunan; SVEF’de azalma, SA’da artma olan ve eşlik eden HT’si olan hastalarda, SİSH’nin daha fazla görüldüğü sonucuna ulaşıldı.Öğe The role of oligoclonal band count and IgG index in treatment response and disease activity in multiple sclerosis(Elsevier Sci Ltd, 2024) Taşkıran, Esra; Terzi, Murat; Helvacı, Elif Merve; Eser, Meltem Zeycan; Avcı, Bahattin; Faruk, Turan Ömer; Yetkin, Mehmet Fatih; Çam, MustafaBackground/aim Multiple sclerosis (MS) is an inflammatory demyelinating central nervous system (CNS) disease. Among the paraclinical tests, brain and spinal Magnetic Resonance Imaging (MRI) is primarily involved in the diagnosis process, and cerebrospinal fluid (CSF) analysis is fundamental in diagnosing MS and the differential diagnosis. A positive relationship was demonstrated between oligoclonal band (OCB) positivity, CSF band number and immunoglobulin G(IgG) index. The study aimed to evaluate whether the number of OCB can predict disease activity and determine a correlation with the IgG index. Methods Our study included 401 MS patients who had relapsing-remitting multiple sclerosis (RRMS), primary progressive multiple sclerosis (PPMS), secondary progressive multiple sclerosis (SPMS), clinic isolated syndrome (CIS), radiologic isolated syndrome (RIS), Neuromyelitis optica spectrum disorder (NMOSD) and Acute disseminated encephalomyelitis (ADEM) with OCB number groups of 2–4, 4–8, 8–12, and 12 and above. Results No significant correlation was observed between IgG index, pre-and post-treatment EDSS (Expanded Disability Status Scale Scores) and disease-modifying therapies (DMT). Drug response was better in the patient group with band number between 2 and 8 and post-treatment EDSS scores were lower (1.62±0.44). Conclusion The study results suggested that band number may be as valuable as the IgG index and a predictive biomarker for disease activity.
