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    A Case Report of AIDS Dementia Complex
    (Gazi Univ, Fac Med, 2013) Kamisli, Suat; Kamisli, Ozden; Gonullu, Sinan; Ciplak, Sibel
    Involvement of nervous system is frequently seen in patients with Acquired Immune Deficiency Syndrome (AIDS). AIDS dementia complex (ADC) is characterized by progressive decline of cognitive and psychomotor functions, and often occurs in the terminal phase of the disease. While our patient was being followed up with the diagnosis of dementia and parkinsonism, clinical signs rapidly progressed. Other conditions that might cause similar symptoms were searched and the patient was diagnosed with ADC based on the clinical, laboratory, and radiological findings. Here, we are reporting a patient with advanced acquired immunodeficiency syndrome (AIDS) who developed dementia as an initial manifestation.
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    Evaluation of lipid levels and LDL-C/HDL-C ratio as possible risk markers of intracerebral hemorrhage
    (Cukurova Univ, Fac Medicine, 2022) Adiguzel, Ahmet; Ciplak, Sibel; Ozturk, Unal
    Purpose: The aim of this study is to analyze the utility of lipid parameters individually and the low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio as a possible risk marker for intracerebral hemorrhages (ICH). Materials and Methods: This was a multicenter, retrospective case-control study that included 226 patients with ICH and 226 controls. Lipid parameters were evaluated after 12 h of fasting in patients whose ICH was confirmed by brain computed tomography, and no underlying vascular, traumatic, or metabolic cause could be found. Results: The mean LDL-C levels and mean total cholesterol (TC) levels did not differ in in the patient and control groups. The mean HDL-C levels in the patient groups were significantly lower whereas triglyceride (TG) levels were significantly higher. In the patient and control groups, LDL-C/HDL-C ratio was 2.65 +/- 1.10 and 2.94 +/- 1.13 (p=0.006), TG/HDL-C ratio was 3.60 +/- 2.72 and 4.47 +/- 3.25 (p=0.002), and TC/HDL-C ratio was 4.37 +/- 1.49 and 4.83 +/- 1.56 (p=0.002), respectively. Conclusion: Increased TG and decreased HDL-C levels were found to be associated with ICHs. However LDL-C/HDL-C, TC/HDL-C, and TG/HDL-C ratios were low in the patient group. Therefore, we can conclude that these lipid ratios give clearer and more significant results in determining the risk of hemorrhage.
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    Prognostic value of glucose fluctuation in patients undergoing thrombolysis or thrombectomy due to acute ischemic stroke
    (Springer, 2021) Ciplak, Sibel; Adiguzel, Ahmet; Ozturk, Unal; Akalin, Yahya
    Background Hyperglycemia during acute ischemic stroke is associated with worse outcomes, and this glucose altitude may persist in the initial days. In this study, we investigate the effect of glucose fluctuations in the first 4 days in patients diagnosed with acute ischemic stroke and who underwent ivr-tPA +/- interventional thrombectomy or only interventional thrombectomy on stroke prognosis. Study was designed bicentered retrospective case series. Patients older than 18 years were included and those suitable for acute treatment, treatment indications, contraindications, and treatment management of hyperglycemia were selected according to the 2018 American Stroke Association guidelines. The effect of fasting glucose values of patients in the first 4 days on admission and 24th hour NIHSS scores, duration of hospitalization, disability, mortality, and prognosis were analyzed. We aimed to demostred the effect of the first 4-day glucose values measured in patients treated in a stroke center on clinical prospect. Results One hundred and seventy-six patients were included in the study. Group 1 included 30 (17%) patients with severe clinical condition (NIHSS at admission >= 16), and Group 2 comprised 146 (83%) patients with moderate and mild clinical condition (NIHSS at admission < 16). The glucose values of Groups 1 and 2 were found as follows: day 1 (admission): 178.7 +/- 10.3 mg/dl and 138.3 +/- 54.9 mg/dl, day 2: 197.7 +/- 99.8 mg/dl and 137.6 +/- 51.8 mg/dl, day 3: 186.1 +/- 97.6 mg/dl and 127.5 +/- 50.0 mg/dl, and day 4: 169.2 +/- 85.0 mg/dl and 126.7 +/- 49.3 mg/dl (p < 0.05). Mortality risk of patients with glucose >= 200 mg/dl was 43.5% on day 1 (p > 0.05), 57.1% on day 2, 68.4% on day 3, and 76.5% on day 4 (p < 0.05). Conclusions The glucose level of patients in severe clinical condition peaked on the second day and that 4 days of resilient severe hyperglycemia is a negative risk factor for sequela and mortality.
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    The Role of the Low-Density Lipoprotein/High-Density Lipoprotein Cholesterol Ratio as an Atherogenic Risk Factor in Young Adults with Ischemic Stroke: A Case-Control Study
    (Mdpi, 2023) Ciplak, Sibel; Adiguzel, Ahmet; Deniz, Yusuf Ziya; Aba, Melike; Ozturk, Unal
    Dyslipidemia is a major atherogenic risk factor for ischemic stroke. Stroke patients tend to have high levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) and low levels of high-density lipoprotein cholesterol (HDL-C). Therefore, it is noteworthy that there has been an increase in ischemic stroke cases in young and elderly individuals in recent years. This study investigated the TC/HDL-C ratio and the LDL-C/HDL-C ratio, which may be more specific and common lipid parameters in young patients with ischemic stroke. This study aimed to demonstrate the sensitivity and specificity of TC/HDL-C and LDL-C/HDL-C ratios as atherogenic markers for young adult ischemic strokes. This trial was conducted as a retrospective case-control study. A total of 123 patients (patient group) and 86 healthy individuals (control group) aged 18-50 years were randomly selected from four different hospitals. Lipid parameters and TC/HDL-C and LDL-C/HDL-C ratios were compared between these two groups. The mean age was 38.8 +/- 7.3 years in patients and 37.7 +/- 9 years in controls (p > 005). The HDL-C levels were 39.1 +/- 10.8 mg/dL in patients and 48.4 +/- 13.8 mg/dL in controls (p < 0.001). LDL-C/HDL-C ratios were 3.23 +/- 1.74 and 2.38 +/- 0.87, and TC/HDL-C ratios were 5.24 +/- 2.31 and 4.10 +/- 1.25 in the patient and control groups, respectively (p < 0.001). The LDL-C/HDL-C and TC/HDL-C cutoff values in ROC analyses were 2.61 and 4.40 respectively; the AUCs (95% CI) were determined to be 0.680 (0.608-0.753) and 0.683 (0.610-0.755) (p < 0.001), respectively. An increased risk of stroke was observed in those with a high LDL-C/HDL-C ratio (OR = 1.827; 95% CI = 1.341-2.488; p < 0.001). Our study obtained similar results when we compared the mean TC and LDL-C levels between the two groups. However, considering the TC/HDL-C and LDL-C/HDL-C ratios, it is noteworthy that there was a significant difference between the patient and control groups.