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Öğe Combined Antithrombotic Treatment With Aspirin and Clopidogrel for Patients With Capsular Warning Syndrome A Case Report(Lippincott Williams & Wilkins, 2012) Asil, Talip; Ir, Nasif; Karaduman, Fatih; Cagli, Bekir; Tuncel, SedatCapsular warning syndrome is characterized by recurrent transient ischemic attacks and is caused by microthrombosis or hypoperfusion of small-sized vessels. The pathophysiological basis of this syndrome is not well understood and currently a consensus has not been reached on its optimal treatment. In this study, we present 2 cases with favorable clinical outcomes after combined antithrombotic treatment with loading doses of clopidogrel and aspirin.Öğe Does Cervical Radiculopathy Have an Effect on Peripheral Nerve Conduction Studies? An Electrophysiological Evaluation(Karger, 2011) Balci, Kemal; Asil, Talip; Tekinaslan, Ilkay; Ir, NasifBackground: Peripheral nerve neuropathies are more common in patients with cervical radiculopathy (CR) and a proximal lesion along an axon might predispose that nerve to injury at distal sites. To evaluate this hypothesis, the frequency of median nerve neuropathy at the wrist and the frequency of ulnar nerve neuropathy at the elbow were investigated in 80 patients with one-sided CR. Methods: The symptomatic and asymptomatic extremities were compared for the electrophysiological parameters of ulnar and median nerve conduction studies. The patients were divided into three diagnostic subgroups (C5/C6 radiculopathy, C7 radiculopathy and C8/Th1 radiculopathy), and ulnar nerve conduction studies were compared between symptomatic and asymptomatic extremities in each subgroup. Results: Although, the median and ulnar nerves are mainly derived from C8/Th1 roots, we did not observe an increased frequency of ulnar nerve involvement at the elbow (3.7% in symptomatic, 2.5% in asymptomatic extremities) while increased median nerve involvement was present at the wrist (27.5% in symptomatic, 12.5% in asymptomatic extremities). Conclusion: The electrophysiological data and the frequency of ulnar and median nerve neuropathy did not support an etiological association between CR and distal neuropathy. Significance: the association between CR and peripheral neuropathy is associational rather than causative. Copyright (C) 2011 S. Karger AG, BaselÖğe The Effect of Admission Blood Pressure on the Prognosis of Patients with Intracerebral Hemorrhage That Occurred during Treatment with Aspirin, Warfarin, or No Drugs(Informa Healthcare, 2012) Balci, Kemal; Utku, Ufuk; Asil, Talip; Celik, Yahya; Tekinaslan, Ilkay; Ir, Nasif; Unlu, ErcumentBackground. Hypertension is the most important modifiable risk factor for intracerebral hemorrhage (ICH), but blood pressure (BP) management during the acute phase of ICH is still controversial. Approximately one-fourth of ICHs occur during treatment with warfarin or aspirin. Aim. This study was designed to determine the effect of admission BP on the early prognosis of ICH patients by dividing them into three groups (warfarin, aspirin, and no drugs). Methods. Three hundred and sixty-nine patients with supratentorial ICH were divided into three groups according to medication. Each group was evaluated in terms of prognosis and the risk for mortality based on the modified Rankin Scale (mRS) score at discharge (good prognosis: mRS <= 3; poor prognosis: mRS > 3). The effect of admission BP on prognosis was evaluated for each group. Results. The inhospital mortality rate was 72% for ICH patients treated with warfarin, 41.6% for ICH patients treated with aspirin, and 35% for ICH patients treated with no drugs. Admission mean arterial blood pressure (MABP) values were higher in patients with poor prognosis compared with patients with good prognosis for the aspirin (P = .002) and no-drug (P = .001) groups, but not in the warfarin (P = .067) group. Conclusion. A high MABP at admission was found to be an independent predictor of poor prognosis for ICH patients treated with aspirin or with no drugs, but not for ICH patients treated with warfarin.Öğe Intravenous tPA Administration in Patients With Acute Ischemic Stroke: Edirne Experience(Journal Neurological Sciences, 2011) Asil, Talip; Balci, Kemal; Utku, Ufuk; Ir, NasifObjective: Intravenous (IV) thrombolytic therapy is the only approved effective treatment used in patients with acute ischemic stroke. In this study, we aimed at establishing the clinical outcomes of the IV tissue plasminogen activator (tPA) therapy and the main factors affecting the success rate of the treatment. Patients and Methods: Demographic data, radiological and clinical findings of the patients with acute ischemic stroke who were administered IV tPA therapy in our clinic were recorded. During the first 90 days, symptomatic intracranial hemorrhage and death events were reported. On day 90, patients were divided into two groups; patients with 0-2 MRS scores were deemed to have a good prognosis, while patients with 0-1 MRS score were deemed to have an excellent prognosis. The next step was to analyze the factors which affected disease prognosis. Results: The study included 48 patients with acute ischemic stroke. Patients were administered IV tPA therapy between November 2006 and January 2010. The mean age was 64,8 +/- 12,8 and the mean NIH score was 16,8 +/- 5,2. In addition, the mean ASPECT score was 6,7 +/- 2,5 based on the baseline CT scan. A total of 9 (18%) of the patients died within the first 90 days, including 2 (4%) patients with symptomatic intracranial hemorrhage. On day 90, 11 patients (23%) had an excellent prognosis, whereas 22 (46%) had a good prognosis. In the study, baseline NIH scores and ASPECT scores were associated with a good prognosis. Conclusion: Intravenous tPA therapy is an approved therapeutic modality in patients with acute ischemic patients, which prevents disability, although it does not decrease mortality. Our study results suggesting that IV tPA therapy was an effective treatment in patients with acute ischemic disease were also consistent with previous significant study findings.Öğe Visual Hallucinations Induced By Tramadol Overdose: Case Report(Ortadogu Ad Pres & Publ Co, 2010) Ir, Nasif; Celik, Yahya; Balci, Kemal; Inal, Mehmet Turan; Memis, DilekTramadol is a centrally acting analgesic commonly used in the treatment of moderate to severe pain. Visual hallucinations after tramadol overdose has rarely been reported. In this case report, we describe a 15-year-old girl with no medical history with headache, dizziness, nausea, vomiting, drowsiess and visual hallucinations such as white dressing men, prophet and cemetery due to tramadol intoxication. She transferred to the intensive care unit and discharged from hospital on the third day. Early recognition and proper immediate treatment are essential to reversing this complication. This case warns physicians that visual hallucinations to tramadol overdose, an unusual unpredictable adverse reaction, must be kept in mind, underlying mechanisms and therapeutic approach are discussed.