Complete blood count derived indexes such as lymphocyte-to-neutrophil ratio (NLR) may help in predicting pneumonia and prognosis in acute stroke. However, the optimal time point for using these bio...

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.

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.

Objective: The effects of the COVID-19 pandemic on both the physical and psychological well-being of individuals have not yet been clearly understood. Especially during the early period of the pandemic, the most prevalent psychological effects included fear, preoccupation with health, anxiety, and feeling of loneliness caused by a general sense of uncertainty. The incidence of headache was as high as 70% among the mild COVID-19 cases. Findings from the past coronavirus outbreaks indicated that neuropsychiatric symptoms might cause a significant health burden and adversely affect the patients’ quality of life. The present study aimed to investigate the anxiety-related clinical conditions of the patients diagnosed with primary headache, who presented to the neurology polyclinic during the prolonged pandemic period. Methods: The research was designed as a two-center, prospective case-control study. Patients diagnosed with primary headache, who presented to the neurology outpatient clinic, and healthy volunteers without a primary headache diagnosis were included in the study. Data collection tools included the sociodemographic data form, Headache Impact Test, Coronavirus Anxiety Scale Short Form, and COVID-19 Disease Perception Scale. Results: Data collected from a total of 869 participants, including 408 (47%) patients diagnosed with headache and 461 (53%) healthy volunteers, were investigated. The results of the Headache Impact Test-6 suggested a severe effect on quality of life in 187 participants (45.8%) in the headache group and 73 participants (15.8%) in the Control Group (p=0.001). There was coronavirus anxiety in 59 (14.5%) participants with headache and 8 (1.7%) participants in the Control Group (p=0.001). Furthermore, the rate of coronavirus anxiety in participants that had and did not have COVID-19 was 44 (13.7%) and 22 (4.1%), respectively (p=0.001). Conclusion: The study results revealed that patients with headache and COVID-19 presented with a higher rate of coronavirus anxiety than healthy controls and those not diagnosed with COVID-19. Further studies on larger samples are necessary for investigating the long term neuropsychiatric effects of COVID-19 in individuals.

Giriş: D vitamini; immün cevabı, endotel fonksiyonu ve hücre proliferasyonu düzenlenmesi yanında antienflamatuar ve antioksidan fonksiyonları bulunabilen bir hormondur. Bu çalışmamızda amacımız, ülkemizde sık görülen yaşam kalitesini ve çalışma hayatını olumsuz etkileyen migrenin etyopatogenezine ışık tutmak ve gelecekte tedavisine katkı sağlayabilmektir. Materyal ve method: Migren tanısı alan 50 hasta ile 50 sağlıklı birey kontrol grubu olarak alındı. Hasta ve kontrol grubunda serum vitamin D [25(OH)vit D], parathormon, kalsiyum, fosfor, albümin düzeyleri çalışıldı. Bulgular: Migrenli hastalarda D vitamini düzeyi ortalama 18.51±12.05 ng/ml iken kontrol grubunda 12.82±9.06 ng/ml olup, p=0.005 saptandı. Kalsiyum ve albümin düzeyi ise migren hastalarında daha düşük bulundu. Sonuç: Çalışmamızda migren hastalarında D vitamini düzeyi daha yüksek bulunmuştur. Birçok çalışmada D vitamini epizodik migrenli hastalarda düşük saptanmış olmasına rağmen çok sayıda çalışmada da bir ilişki saptanamamıştır ve az sayıda çalışmada da bizim çalışmamızda olduğu gibi D vitamin düzeyi yüksek saptanmıştır. Sonuç olarak migren, kalsiyum ve D vitamini arasındaki ilişki hala tam olarak bilinmemektedir. Bu ilişki belirlenmesi için randomize kontrollü çalışmaların yanı sıra moleküler düzeyde çalışmaların da yapılması patogenezle ilgili daha net bilgiler verebilir.