Person: KAHRAMAN KOYTAK, PINAR
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KAHRAMAN KOYTAK
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PINAR
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Publication Metadata only Accuracy and reliability of magnetic resonance imaging in the diagnosis of idiopathic intracranial hypertension(2022-10-01) ULUÇ, KAYIHAN; ÇİMŞİT, NURİ ÇAGATAY; ILGIN, CAN; DERİCİOĞLU, VOLKAN; KAHRAMAN KOYTAK, PINAR; Kuzan B. N. , ILGIN C., Kuzan T. Y. , DERİCİOĞLU V., KAHRAMAN KOYTAK P., ULUÇ K., ÇİMŞİT N. Ç.© 2022 Elsevier B.V.Purpose: To determine the diagnostic utility of brain magnetic resonance imaging (MRI) findings in patients with idiopathic intracranial hypertension (IIH) and to investigate the significance of evaluating radiological findings together with neurological and ophthalmological data in the diagnosis of IIH. Materials and Methods: All consecutive patients diagnosed with IIH in our tertiary neuro-ophthalmology center between January 1, 2018 and March 15, 2020, were included in the study. The clinical, radiological, and ophthalmological findings of IIH patients were compared with the control group with similar demographic characteristics. Results: A total of 98 patients, 49 cases and 49 controls, were included in the study. Lateral ventricular index had the highest area under the curve (AUC) value (0.945) for prediction of disease group followed by sella height category (AUC = 0.915) and optic nerve tortuosity (AUC = 0.855) According to the multivariate model we developed, caudate index (OR = 0.572, 95% CI 0.329–0.996), lateral ventricle index (OR = 3.969, 95% CI 1.851–8.509) and bilateral optic nerve tortuosity (OR = 22,784, 95% CI 2.432–213.450) were significant predictors for disease group. Conclusion: Tortuosity in the optic nerve, lateral ventricular index and caudate index can be used as MRI parameters supporting the diagnosis of IIH in clinically suspicious cases. A holistic approach to the clinical and radiological findings of the cases in the diagnosis of IIH can prevent overdiagnosis and enable early correct diagnosis.Publication Metadata only Acute flaccid myelitis outbreak through 2016-2018: A multicenter experience from Turkey(ELSEVIER SCI LTD, 2021) TÜRKDOĞAN, DİLŞAD; Unver, Olcay; Turkdogan, Dilsad; Guler, Serhat; Kipoglu, Osman; Gungor, Mesut; Paketci, Cem; Carman, Kursat Bora; Ozturk, Gulten; Genc, Hulya Maras; Ozkan, Mehpare; Dundar, Nihal Olgac; Isik, Ugur; Karatoprak, Elif; Kilic, Betul; Ozkale, Murat; Bayram, Erhan; Yarar, Coskun; Sozen, Hatice Gulhan; Sager, Gunes; Gunes, Ayfer Sakarya; Koytak, Pinar Kahraman; Saygi, Evrim Karadag; Ekinci, Gazanfer; Saltik, Sema; Caliskan, Mine; Kara, Bulent; Yis, Uluc; Aydinli, NurAim: We aim to describe the demographic characteristics, etiology, neurophysiology, imaging findings, treatment, prognosis, and prognostic factors of acute flaccid myelitis. Methods: The clinical data, laboratory test and, magnetic resonance imaging (MRI) results of pediatric patients diagnosed with acute flaccid myelitis according to the Centers for Disease Control criteria between August 1, 2016, and December 31, 2018, from 13 centers in Turkey were reviewed. Results: Of the 34 cases identified, 31 were confirmed (91.2%). Eighteen patients (55.9%) were boys. The median patient age was 4 years (interquartile range 2.5-6.9 years). Most of the patients were admitted in 2018 (n = 27). A preceding history of a febrile illness was reported in all patients, with a median of 4 days (interquartile range 3-7 days) before symptom onset. Thirty-one patients had T2 hyperintensity on spinal MRI, and 18 patients had cerebrospinal fluid pleocytosis. The most common infectious agents were entero/rhinoviruses (n = 5) in respiratory specimens. All patients except one received immunotherapy either alone or in combination. Among 27 patients with follow-up data 24 had persistent weakness. Involvement of four limbs together with an abnormal brain MRI at onset were associated with a poor prognosis. Conclusion: The number of patients with acute flaccid myelitis increased since 2012, spiking with every 2-year interval, largely in the pediatric population. The median age decreases with every outbreak. Clinicians should be aware of the clinical picture for early collection of specimens and early start of rehabilitation programs. Further studies are needed to better characterize the etiology, pathogenesis, risk factors, and treatment of this rare condition. (c) 2020 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.Publication Metadata only Reference jitter values for the sternocleidomastoid muscle with concentric needle electrodes(WILEY, 2021) ULUÇ, KAYIHAN; Kula, Ezgi; Tanridag, Tulin; Kahraman Koytak, Pinar; Uluc, KayihanBackground The aim of this study was to establish reference jitter values for the voluntary activated sternocleidomastoid (SCM) muscle using a concentric needle electrode (CNE). Methods The study included 39 healthy participants (20 female and 19 male) aged 18-77 y. Jitter was expressed as the mean consecutive difference (MCD) of 80-100 consecutive discharges. Filters were set at 1 and 10 kHz. The mean MCDs for all participants were pooled, and the mean value +2.5 SD was accepted as the upper limit for the mean MCD. The upper limit for individual MCD was calculated using +2.5 SD of the upper 10th percentile MCD for individual participants. Results Mean age of the participants was 45 +/- 14.5 y. Mean MCD was 16.20 +/- 2.23 mu s (range: 12-21 mu s), and the upper limit of normal for mean MCD was 21.8 mu s. The mean value for 823 individual jitters was 23.3 +/- 4.61 mu s (range: 6.6-36.9 mu s), and the upper limit of normal for each individual jitter was 34.6 mu s. Conclusions The present findings indicate that upper normal limit for mean MCD is 22 mu s and for individual data it is 35 mu s.Publication Open Access Physical and mental fatigue in myasthenia gravis and its correlation with other symptoms(2022-08-01) ULUÇ, KAYIHAN; KAHRAMAN KOYTAK, PINAR; Akkan Suzan A., Kahraman Koytak P., Uluc K., Tanridag T.Introduction:Muscle weakness and easy fatigability are the clinical hallmarks of myasthenia gravis (MG). However, fatigue perception, which can be seen quite often in myasthenic patients, and its effect on the quality of life, irrespective of motor deficit, has not been elucidated yet. The aim is to evaluate the frequency of fatigue in myasthenic patients with nearly full muscle strength and the effect of fatigue on quality of life by assessing its correlation with other symptoms.Methods:Fifty-three patients with ocular or mild generalized MG in remission or minimal manifestations completed the questionnaires measuring the severity of MG and quality of life (MG Composite Scale and MG-Activities of Daily Living Profile). Both patient group and control group (53 healthy volunteers)completed the scales assessing fatigue [Fatigue Assessment Scale (FAS) and Fatigue Impact Scale (FIS)], depression [Beck Depression Inventory (BDI)] and sleep (Epworth Sleepiness Scale). Disease severity was assessed using MG Foundation of America (MGFA) and MGFA Post-Intervention Status classifications.Results:FAS, FIS physical and BDI scores were significantly higher in patients compared to the control group (p = 0.003, p = 0.001, and p = 0.003, respectively) and fatigue was associated with depression and daytime sleepiness. Inpatient group, depressive symptoms and daytime sleepiness were higher in females (p = 0.019 and p = 0.013). The mean values of FIS total and cognitive scores were higher in patients with generalized MG (p = 0.033 and p = 0.045). Fatigue scores correlated with motor signs.Discussion:Fatigue can be seen in MG independently from muscle weakness and is an important symptom worsening the quality of life.Publication Metadata only Successful treatment of influenza B associated acute necrotizing encephalopathy in an adult using combination of high dose oseltamivir-IVIG-pulse metylprednisolone(2021) TUNCER, EMİNE NEŞE; Erdil, Esra; Vural, Ezgi; Koytak, Pınar Kahraman; Tuncer, Emine Neşe