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Biomedical subjects

Nur Turhan

Publications and source records attributed to Nur Turhan.

6 recordsLinked to original sources

Serum albumin and comorbidity relative to rehabilitation outcome in geriatric stroke, and possible links with stroke etiology.

Factors that describe the disability status of the stroke patient on discharge are important when starting a rehabilitation program, both from a psychosocial and a financial point of view. The objective of this study was to assess how comorbidity and serum albumin levels relate to rehabilitation outcome in geriatric stroke patients. Another aim was to assess whether stroke etiology (ischemic or hemorrhagic) influences these links. Medical records of 80 patients (68 ischemic and 12 hemorrhagic strokes) older than 65 years, who had suffered their first stroke, were investigated. Functional performance levels at admission and discharge were evaluated using the Functional Independence Measure (FIM). Length of stay in hospital was recorded. Serum albumin levels and comorbidity scores on admission were noted. Correlations between these variables and differences between the groups categorized according to stroke etiology were analyzed. In the group of geriatric stroke patients as a whole, serum albumin level was correlated with FIM score at admission and discharge. Comorbidity score was negatively correlated with length of stay. In the ischemic stroke subgroup, serum albumin level was positively correlated with length of stay and with functional gain, and comorbidity score was negatively correlated with functional gain. Analysis of the data for the hemorrhagic stroke subgroup revealed none of these correlations. It was concluded that serum albumin level and comorbidity are useful indices in geriatric ischemic stroke patients for predicting functional outcome and time spent in rehabilitation.

Aged↗

Impact of stroke etiology, lesion location and aging on post-stroke urinary incontinence as a predictor of functional recovery.

This retrospective study aims to assess the relationship of age, gender, lesion location, stroke etiology and recurrence of stroke to post-stroke urinary incontinence, and to evaluate its impact on functional recovery in patient subgroups with different etiologies, lesion locations and ages. One-hundred-and-sixty-three stroke patients participated in the study. Among them, 141 had detailed imaging tests for the definition of lesion locations. Post-stroke urinary incontinence was defined as an inability to respond to questions regarding toilet needs, evidence of elevated post-stroke urinary incontinence and retention. Successful rehabilitation was described as a total functional independence measure score over 80 at discharge. Cerebrovascular lesion locations were categorized as cortical, subcortical and disseminated. The study found that post-stroke urinary incontinence had a significant negative impact on successful stroke rehabilitation. Post-stroke urinary incontinence was a better indicator of negative functional outcome in hemorrhagic versus ischemic stroke patients and patients with cortical versus subcortical lesions. The incidence of post-stroke urinary incontinence in patients aged over 75 years was higher than in patients under 75 years (P=0.031). In conclusion, post-stroke urinary incontinence was a strong negative predictor of poor outcome in all stroke subgroups. It was related to age, but not to any other pre-selected factor investigated in this study.

Age Factors↗

Hemorrhagic transformation in stroke patients.

OBJECTIVE: To identify the predictors of hemorrhagic transformation in stroke patients and to evaluate the impact of hemorrhagic transformation on rehabilitation outcome. DESIGN: The records of 203 hemiplegic patients hospitalized for rehabilitation after the acute phase of stroke were retrospectively analyzed. In 121 cases, the first computed tomographic scan and a repeat scan were compared to determine whether hemorrhagic transformation occurred. Correlations between the occurrence of hemorrhagic transformation and use of anticoagulants, antiaggregants, and antiedema drugs were evaluated. Admission and discharge FIM trade mark and Adapted Patient Evaluation Conference System scores were noted, and functional gain was calculated from these. These data were also analyzed for associations with hemorrhagic transformation. RESULTS: Hemorrhagic transformation was detected in 39 of the 121 cases. There was no significant difference in functional outcome between patients who did and did not show hemorrhagic transformation. Although not statistically significant, the use of antiedema drugs was found to increase the risk of hemorrhagic transformation, whereas the use of anticoagulants and antiaggregants had no influence. CONCLUSIONS: Hemorrhagic transformation of an ischemic lesion does not affect rehabilitation outcome in stroke survivors. The study results favor the use of anticoagulants and antiaggregants in the acute phase unless these drugs are contraindicated by the patient's condition. Still, prospective trials are needed to make definite conclusions.

Acute Disease↗

Delayed spinal cord injury after high-voltage electrical injury.

Delayed spinal cord injury is a rare complication of high-voltage injury. The diagnosis of this scenario is difficult because radiologic imaging techniques lack sensitivity. Frequent neurologic assessments, although difficult to perform in the early stages of such multisystem traumas, are required for accurate diagnosis.

Adult↗