Browsing by Author "Kotan, Zeynep"
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Item Differences in sociodemographic characteristics, clinical features and serum liver function tests of male cannabis and synthetic cannabinoid users(Cumhuriyet Üniversitesi, 2017-08-01) Kotan, Vahap Ozan; Yücens, Bengi Baz; Kotan, Zeynep; Okay, İhsan Tuncer; Tikir, Baise; Göka, Erol; Özkaya, Güven; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-0297-846X; A-4421-2016; 16316866500Objective: Synthetic cannabinoid (SC) use has recently become a growing substance abuse problem, with serious harmful clinical effects. Young males, especially cannabis (C) users, are at great risk of SC use. The aim of this study is to determine sociodemographic characteristics, clinical features and serum liver function tests of SC users and compare with those of C users. Methods: Out of 118 SC users applied to outpatient clinic of Ankara Numune Training and Research Hospital Alcohol and Substance Addiction Treatment Center, 74 males included in this cross-sectional study. Patients with a concurrent use of any medication or substance other than C/SCs or patients with any physical illness which could affect serum liver function tests were excluded. 44.6% (n=33) of 74 patients were only SC users at least for last three months and 55.4% (n=41) were combined C and SC (C&SC) users. SC users were compared with 34 age and BMI-matched only C using males. Results: Rates of being single and divorced; rates of living with friends and alone were found to be higher in SC users. Adverse effects and withdrawal sypmtoms were found to be similar in C users and SC users. According to serum liver function test results, levels of gama-glutamil transpeptidase, alkaline phosphatase, total/direct bilirubin, albumin, prothrombin time and international normalized ratio were similar. Serum aspartate aminotransferase levels (31.2±22.0 IU/L and 41.5±21.5 IU/L respectively, p=0.026) and serum alanine aminotransferase levels (28.4±18.9 IU/L and 44.3±25.9 IU/L respectively, p=0.015) differed between C users and C&SC users. Results in this study revealed that increased serum levels of aminotransferases were especially associated with combined use of C and SCs. Conclusions: C abuse seems to be a precursor of SCs abuse, and risk of starting SCs use could be bigger for C users, who live alone or with friends, whereas living together with a family could be preventative. Combined use of C and SCs seem to increase the risk of hepatocellular injury compared to either C or SCs alone.Item Melankolik özellikler gösteren majör depresif bozukluk tanısı almış hastalarda serum beyin kaynaklı nörotrofik faktör (BDNF), vasküler endotel büyüme faktörü (VEGF) ve leptin düzeyleri(Uludağ Üniversitesi, 2009) Kotan, Zeynep; Kırlı, Selçuk; Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı.Bu çalışmanın amacı biyolojik faktörlerin majör rol oynadığı bilinen ağır şiddette melankolik depresyon hastaları ve sağlıklı kontrollerden oluşan iki grup oluşturarak, hasta ve kontrol grubunda BDNF, VEGF ve leptin serum düzeylerini belirlemek ve birbiriyle karşılaştırmaktır. Bu amaçla psikiyatrik tedavi kullanmayan Major Depresif Bozukluk - Melankolik Özellikler Gösteren tanısı alan 40 hasta ile 40 sağlıklı gönüllü çalışmaya dahil edilmiştir. Tüm katılımcıların demografik bilgileri alınmış, fizik muayeneleri yapılmış, rutin olarak istenen tetkiklerin yanı sıra BDNF, VEGF ve leptin serum düzeyleri belirlenmiştir. Hasta grubunun depresyon öyküleri alınarak Hamilton Depresyon Değerlendirme Ölçeği (HAM-D) ile Hamilton Anksiyete Değerlendirme Ölçeği (HAM-A) ölçeği uygulanmıştır.Çalışmaya alınan hasta ve kontrol grubunda BDNF, VEGF ve leptin düzeyleri açısından anlamlı bir fark saptanmamıştır. Özkıyım girişimi olan hastalarda BDNF düzeylerinin diğer hastalardan ve kontrol grubundan düşük olduğu; BDNF düzeyleri ile depresif atak sayısı arasında da negatif korelasyon bulunduğu tespit edilmiştir. VEGF düzeylerinin HAM-D ile değerlendirilen depresyon şiddeti arttıkça düştüğü belirlenmiştir. Leptin düzeylerinin her iki grupta vücut kitle indeksi ile doğru orantılı olduğu ve kontrol grubunda kadın hastaların leptin düzeylerinin erkeklerden yüksek olduğu saptanmıştır. Sonuç olarak BDNF, VEGF ve leptin düzeyleri ile ağır şiddette melankolik özellikli depresyon arasında ilişki saptanmamıştır. BDNF'nin depresyonun yinelemeleri ve özkıyım girişimi varlığı ile; VEGF'nin ise depresyonun şiddeti ile ilişkili olduğu düşünülmüştür.Publication Metabolic, endocrinologic and cardiac effects of amisulpride: A 24-week follow-up study(Sage Publications Ltd, 2011-12-01) Kotan, Zeynep; Ertepe, Berrin; Akkaya, Cengiz; SARANDÖL, EMRE; AKKAYA, CENGİZ; Sarandöl, Emre; Özkaya, Güven; ÖZKAYA, GÜVEN; Kirli, Selçuk; KIRLI, SELÇUK; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-0297-846X; A-4421-2016; ABE-1716-2020Background: Amisulpride is a second-generation antipsychotic which has been proved to be effective in the control of both positive and negative symptoms of schizophrenia. In this study we aimed to determine metabolic, endocrinologic and cardiac effects of amisulpride commonly used in our clinical practice.Methods: A total of 18 patients (11 males, 7 females) diagnosed with schizophrenia received amisulpride at the dosage of 800 mg/day and were followed up for 24 weeks. Positive and negative psychotic symptoms, extrapyramidal and sexual side effects, metabolic, endocrinologic and cardiac parameters were evaluated at regular intervals.Results: Significant improvement in both positive and negative symptoms was observed in patients starting from the second week of treatment. Prolactin levels increased significantly both in men and women starting from the measurement on day 4. Prolactin elevation was significantly higher in women than in men. Increase in total cholesterol level became significant at week 24. No other significant difference was observed between weeks 1 and 24 regarding the other parameters.Conclusions: The clinical data from the present study supports the fact that amisulpride is an effective and safe antipsychotic drug, but elevates prolactin levels in both sexes.Item Pain, daytime sleepiness, anxiety and depression levels of patients with chronic neuropathic pain syndromes(Ege Üniversitesi Tıp Fakültesi, 2015-12-08) Kotan, Zeynep; Kotan, Vahap Ozan; Demir, Aylin Bican; Bora, İbrahim; Özkaya, Güven; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-0297-846X; 0000-0001-6739-8605; A-4421-2016; V-7170-2017; 18036596400; 6602914249; 16316866500Objective: The current study aims to determine pain, daytime sleepiness, anxietyand depression levels of patients with chronic neuropathic pain and compare different clinical conditions causing neuropathic pain in terms of these variables. Method: 241 patients (105 patients with diabetic neuropathy, 39 patients with fibromyalgia, 27 patients with carpal tunnel syndrome, 27 patients with radiculopathy, 22 patients with trigeminal neuralgia and 21 patients with postherpetic neuralgia) were included in the study. The assessments were performed using socio-demographic data form, Visual Analog Scale (VAS), Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), Epworth Sleepiness Scale (ESS) and Hospital Anxiety and Depression Scale (HAD). Results: Evaluation of pain with VAS and LANSS showed no statistical difference among subgroups. Scores of LANSS and VAS were positively correlated with each other. ESS scores were found to be above the cut-off point (> 10) in all subgroups. LANSS, but not VAS scores were positively correlated with ESS scores. Depression scores were above the cut-off point (> 7) in diabetic neuropathy, fibromyalgia and trigeminal neuralgia groups and anxiety scores were above the cut-off point (> 10) in diabetic neuropathy, fibromyalgia, trigeminal neuralgia and carpal tunnel syndromegroups. No correlation was found between scores of both VAS and LANSS and scores of HADS. Depression scores correlated positively with ESS scores (r=0.153, p<0.05). Conclusions: Daytime sleepiness, depression and anxiety are associated comorbidities with different neuropathic pain syndromes. Neuropathic character, but not the intensity of pain is associated with daytime sleepiness. Pain intensity does not predict anxiety and depression levels. Depression, but not anxiety shows a positive correlation with daytime sleepiness. These results might have implications for the better understanding of comorbidities in different neuropathic pain syndromes.Item A patient using ziprasidone with polydipsia, seizure, hyponatremia and rhabdomyolysis(Pergamon-Elsevier Science, 2006-12-30) Akkaya, Cengiz; Sarandöl, Aslı; Sivrioğlu, Enver Y.; Kotan, Zeynep; Kirli, Selçuk; Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı.; 14061855100; 14020405100; 14062563200; 15044759000; 14019745700We aimed to report a case with rhabdomyolysis related to hyponatremia and/or its correction. A 32-year-old male schizophrenic patient on ziprasidone treatment was admitted to the hospital following a seizure. Patient had primary polydipsia and secondarily developed hyponatremia. After the correction of hyponatremia, due to the high liver enzyme levels, be was diagnosed as rhabdomyolysis. Although the role of antipsychotics in this situation is speculative, development of rhabdomyolysis related to hyponatremia and/or its correction should not be underestimated and should be assesed throughly.Item Psychopathology, psychosocial factors and quality of life in patients with myasthenia gravis(Journal of Neurological Sciences, 2016-08-11) Kotan, Vahap Ozan; Kotan, Zeynep; Aydın, Birgül; Yalvac, Hayriye Dilek; Taşkapılıoğlu, Özlem; Karlı, Hamdi Necdet; Özkaya, Güven; Sarandöl, Aslı; Turan, Ömer Faruk; Kırlı, Selçuk; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı.; 0000-0003-0297-846X; A-4421-2016; AAK-6623-2020; 23037226400; 57193973560; 16316866500; 14020405100; 23037113500; 14019745700Introduction: Myasthenia Gravis (MG) is a chronic disease which affects physical, psychological and social functioning of patients. In this study we aim to determine psychiatric comorbidity, some psychosocial factors and their relations with quality of life in patients with MG. Methods: A total of 52 patients underwent psychiatric examination and the following scales were applied: Socio-demographic data form, Hospital Anxiety and Depression Scale (HADS), Quality of Life (QOL) Scale Short Form 36 (SF-36), Psychosocial Adjustment to Illness Scale-Self report (PAIS-SR), Multidimensional Scale of Perceived Social Support (MSPSS) and Posttraumatic Growth Inventory (PTGI). Results: Among 52 patients with MG, 36.5% (n=19) had no psychiatric diagnosis; 21.2% (n=11) had adjustment disorder; 19.2% (n=10) had depression and 23.1% (n=12) had anxiety disorder. Patients with a psychiatric diagnosis had lower scores in general health, vitality, social functioning, emotional role and mental health domains of SF-36. PAIS-SR scores, total MSPSS and friends scores were signifitcantly higher in patients without a psychiatric diagnosis. Significant correlaions of psychosocial factors with quality of life were determined. Conclusion: In MG patients, there is a high prevalence of psychopathology and it is associated with quality of life, perceived social support and psychosocial adjustment of the patients. Quality of life is reduced in both physical and mental aspects. Diagnosis and treatment of psychopathology in MG patients is crucial to decrease disease burden.Item Serum glial cell line-derived neurotrophic factor levels and impulsivity in heroin addiction: a cross-sectional, case-control study of 129 heroin addicts(Aves, 2018) Kotan, Vahap Ozan; Yüksel, Rabia Nazik; Kotan, Zeynep; Okay, İhsan Tuncer; Topçuoğlu, Canan; Bayram, Şenol; Göka, Erol; Özkaya, Güven; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-0297-846X; A-4421-2016; 16316866500OBJECTIVE: Glial cell line-derived neurotrophic factor (GDNF), being a protective of dopaminergic neurons, is reported to modulate addictive behaviours and have a role as a negative regulator for biochemical and behavioural adaptations to drug abuse. We aimed to reveal impulsivity and serum GDNF levels in patients with heroin addiction and investigate their relationships in order to contribute to the understanding of behavioural aspects and biological mechanisms in heroin addiction via this study. METHODS: This study was performed at the Department of Psychiatry of Ankara Numune Training and Research Hospital, Turkey. We recruited 129 heroin-dependent patients and 90 age, sex, and smoking-matched healthy controls with no major psychopathology. Barratt Impulsivity Scale-11, Hospital Anxiety and Depression Scale (HADS) and sociodemographic data form were applied to all participants. Laboratory analysis for serum GDNF levels was performed for each participant's blood sample. RESULTS: Total impulsivity scores and scores of Attentional Impulsivity, Motor Impulsivity, and Unplanned Impulsivity subscales were all higher in heroin addicts compared to the controls. Heroin addicts had also lower serum GDNF levels and lower GDNF levels were associated with high impulsivity and high HADS scores in heroin addicts. CONCLUSION: Decrement in GDNF levels in heroin addiction seems as to be an important data which could be associated with impulsivity, anxiety, and depressive symptoms. GDNF could find a prominent place among the target molecules in the treatment of heroin addiction.Publication Sleep measurements in women with dysthymic disorder and insomnia(Springer, 2015-01-01) Kotan, Zeynep; Bican, Aylin; Kotan, Vahap Ozan; Bora, İbrahim; Yalvac, Hayriye Dilek; Özkaya, Güven; Akkaya, Cengiz; BİCAN DEMİR, AYLİN; BORA, İBRAHİM HAKKI; ÖZKAYA, GÜVEN; AKKAYA, CENGİZ; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı.; 0000-0003-0798-4850; 0000-0002-1456-2499; A-4421-2016; ENI-7759-2022 ; CEN-7664-2022; EKJ-8427-2022To determine the effects of trazodone, mirtazapine and hydroxyzine on sleep profiles of dysthymic disorder (DD) women with selective serotonin reuptake inhibitor (SSRI) treatment and compare their polysomnographic measurements with controls. Among 36 patients trazodone receiving (n=9), mirtazapine receiving (n=8), hydroxyzine receiving (n=8) and only SSRI receiving (n=11) patients were compared to each other and to controls in terms of polysomnographic (PSG) findings. Rapid eye movements (REM) ratio and sleep onset time (SO) were higher; slow wave sleep (non-REM3) ratio and total sleep duration (TSD)) and sleep efficiency (SE) were lower in patients when compared with controls. Increased REM ratio and SO; decreased non-REM3 ratio and TSD and SE were found in both only SSRI receiving patients and hydroxyzine receiving patients when compared with controls. Only SSRI receiving patients also showed increased non-REM1 ratio. Trazodone or mirtazapine receiving patients showed no difference than controls. When PSG assessment is considered, it can be suggested that both trazodone and mirtazapine improve sleep problems in DD patients with SSRI treatment, but hydroxyzine does not.