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AĞAN YILDIRIM, KADRİYE

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    Risk assessment of obstructive sleep apnea syndrome and other sleep disorders in multiple sclerosis patients
    (ELSEVIER, 2021) GÜNAL, DİLEK; Sunter, Gulin; Ozden, Hatice Omercikoglu; Vural, Ezgi; Gunal, Dilek Ince; Agan, Kadriye
    Background: The aim of the present study was to determine the possible risk of OSAS in patients with MS through the STOP-BANG questionnaire, and to confirm the pre-diagnosis of OSAS by recording polysomnographic investigation in individuals with high risk. In addition, the relationship between OSAS risk and fatigue, sleepiness, depression, and disability status will be examined. Methods: Totally 97 patients with multiple sclerosis including 36 males and 61 females with an age average of 39.92 +/- 9.11 years. All participants completed the following questionnaires: STOP-Bang, Fatigue Severity Scale (FSS), Epworth sleepiness scale (ESS), Beck Depression Inventory (BDI); disability status of the participants was assessed by Expanded Disability Status Scale (EDSS). Polysomnographic sleep record was applied to the patients with high risk of OSAS according to STOP-BANG test scores. Results: The STOP_BANG questionnaire revealed that 24.7% of the patients were screened as high risk for OSA. Approximately 11.3% of the patients were detected positive for OSAS based on PSG recording. Comparison of MS patients with high risk of OSA with others suggested a significant difference in terms of the age (p = 0.01). ESS positive scores were significantly correlated with positive STOP BANG outcomes (p < 0.001). ESS positive scores were negatively correlated with positive PSG outcomes. Conclusion: The prevalence of OSAS in MS patients based on questionnaire and PSG was found consistent with literature. Similar to the general population, increasing age was found as a risk factor for OSAS in patients with MS. STOP-BANG test may not be an adequate test to diagnose OSAS, especially in MS patients with high fatigue scores.
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    Predictors of refractoriness in a Turkish status epilepticus data bank
    (ACADEMIC PRESS INC ELSEVIER SCIENCE, 2009) MİDİ, İPEK; Agan, Kadriye; Afsar, Nazire; Midi, Ipek; Us, Onder; Aktan, Sevinc; Aykut-Bingol, Canan
    Refractory status epilepticus (RSE) is known to constitute approximately 10-50% of all cases of status epilepticus (SE) and is associated with significant morbidity and mortality. In the present study, data from a prospectively collected SE database were analyzed. Patients with RSE (defined as a SE episode requiring a second line of intravenous treatment following intravenous phenytoin) were compared with patients with nonrefractory SE (NRSE); 290 episodes of SE were identified, of which 108 (38%) were defined as RSE. Univariate analysis revealed that age, female gender, SE type, SE duration, and acute etiology were associated with refractoriness, whereas electroencephalographic patterns were not. Nonconvulsive SE, which is probably associated with delays in treatment initiation, was a predictor of RSE, although it was not retained as a predictor in multivariate analysis. In the latter analysis, female gender (odds ratio: 1.815, 95% Cl: 1.053-3.126) and acute etiology (odds ratio: 0.619, 95% Cl: 0.429-0.894) were shown to be the only significant independent predictors of refractoriness. (C) 2009 Elsevier Inc. All rights reserved.
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    Episodes of status epilepticus in young adults: Etiologic factors, subtypes, and outcomes
    (ACADEMIC PRESS INC ELSEVIER SCIENCE, 2013) MİDİ, İPEK; Ozdilek, Betul; Midi, Ipek; Agan, Kadriye; Bingol, Canan Aykut
    The aim of this study was to evaluate the type, duration, etiology, treatment, and outcome of status epilepticus (SE) episodes, among patients aged 16-50 years. A total of 101 SE episodes in 88 young adult patients fulfilled our criteria. The mean age was 32 years. Status epilepticus episodes were most frequently observed in patients 21-30 years of age. A total of 53% of the patients were male, and 57% had pre-existing epilepsy. Seventy of the 101 episodes were convulsive SE. The most common etiology was withdrawal of or change in antiepileptic drugs (AEDs), seen in 31% of the SE episodes. This study included treatment of SE with traditional AEDs. Sixty-six episodes were treated successfully with intravenous infusion of 18-mg/kg phenytoin, and six episodes were treated with 10-mg/kg phenytoin. A total of 28% of the SE episodes remained refractory to first-line treatment, which was related to the duration of SE and mortality. The outcome was death in 14% of the patients due to underlying etiologies in the hospital. (C) 2013 Elsevier Inc. All rights reserved.