The Aggregate Index of Systemic Inflammation as a Predictor of Mortality in Stroke Patients.

Background and objectives Stroke, a leading cause of mortality and disability, involves significant inflammation both before and after onset. This study investigates the relationship between the aggregate index of systemic inflammation (AISI) and mortality in stroke patients. The objective is to determine if AISI, an easily accessible biomarker, can predict stroke prognosis. Materials and methods In this retrospective study, the medical records of patients who presented to Harran University Neurology Clinic between January 2018 and September 2023 were reviewed. A total of 200 patients, 106 of whom were diagnosed as having an ischaemic stroke and 94 of whom were diagnosed as having a haemorrhagic stroke, were included in the study. A control group was also formed, which consisted of 100 people of similar age and sex with the patient group. The controls had neither chronic disease nor chronic drug use. Using biochemical and full blood count parameters, neutrophil-to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), monocyte to lymphocyte ratio (MLR), neutrophil to high-density cholesterol ratio (NHR), monocyte to high-density cholesterol ratio, systemic immune inflammation index (SII), systematic immune response index (SIRI) and the AISI were calculated for all patients and the control group. Results A comparison of the two groups revealed significantly higher NLR, NHR, PLR, LMR, MLR, SII, SIRI and AISI values compared with the controls. NLR, PLR, SII, SIRI and AISI values were significantly higher in haemorrhagic stroke than in ischaemic stroke. Elevated NLR level and SII were correlated to mortality (respectively p:0.000, p = 0.017). SIRI (p = 0.189) and AISI (p = 0.162) were not correlated to mortality. However, receiver operating characteristic curve analysis determined that mortality increased for patients with AISI values above 507.45 (p = 0.003). Conclusions The AISI was found to be high among stroke patients, especially in haemorrhagic strokes. A relationship was observed between the increase in AISI above a certain value and mortality. The AISI is an accessible biomarker that shows inflammation in stroke patients. Therefore, it can be used to predict the prognosis of stroke.

Practices of Patient Relatives Aimed at Preventing Pressure Injuries and Their Experiences of Coping with the Burden of Care: A Qualitative Study.

OBJECTIVE: To determine the practices and coping experiences of the relatives of patients with pressure injuries (PIs). METHODS: The authors used a qualitative, phenomenologic research design. They interviewed 20 relatives of patients with PIs face-to-face using an in-depth semistructured interview form. The data were analyzed using the Colaizzi phenomenologic method. RESULTS: Three categories, 8 main themes, and 22 subthemes emerged from the interviews. The category of "the impact of the need for care on the lives of the patient's relatives" was analyzed according to psychological, social, and physical effects. In the category of "practices to prevent pressure injuries," two themes emerged: practices toward the patient and the environment. Relatives of individuals with PIs have psychological, physical, and social needs. CONCLUSIONS: Providing care to a patient with PIs has psychological, social, and physical effects on the patient's relatives. The care burden mostly affects these caregivers negatively, and they mainly need time for themselves and moral and companion support.

The relationship between sleep disorders with patients' demographic-clinical characteristics and quality of life in patients with multiple sclerosis.

OBJECTIVES: In this study, the effect of sleep disturbance on the quality of life in MS patients and its relationship between demographic and clinical characteristics of the patients were investigated. METHODS: 67 MS patients and 51 healthy individuals were included in our study. The patient group consisted of 43 women and 24 men. The control group consisted of 32 women and 19 men. Demographic and clinical characteristics of the patients; age, gender, duration of illness, annual number of attacks, treatments, and medical history were recorded and neurological examinations of all patients were performed and disability was determined for each patient with Kurtzke's expanded disability status scale (EDSS). Evaluations were made using demographic data, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Expanded Disability Status Scale (EDSS), Fatigue Severity Scale, Hospital Anxiety and Depression Scale, Berlin Questionnaire and Multiple Sclerosis Quality of Life (MSYK) - 54 Instrument. RESULTS: We found that the quality of life was significantly impaired in MS patients compared to healthy controls (p < 0.001). And we found that this was related to the presence of progressive MS and chronic fatigue among the clinical features of the patient, sleep-disordered breathing among sleep disorders, poor sleep quality, comorbid anxiety and depression (p = 0.001, p:0.009, p = 0.022, p = 0.007, p < 0.001 and p = 0.001, respectively). CONCLUSION: All these findings show that sleep disorders in patients with MS are a condition that should be questioned and treated in the follow up of the disease, otherwise it may affect the quality of life of patients negatively.

Interleukin-33 and oxidative stress in epilepsy patients.

OBJECTIVE: Inflammation and oxidative stress plays an important role in the etiology of epilepsy. Interleukin-33 (IL-33), a new member of the cytokine family associated with interleukin-1 (IL-1), has been found to play a role in pathogenesis of central nervous system diseases and cause the production of proinflammatory cytokines and oxidative stress molecules. Our aim was to investigate IL-33 and oxidative stress values (total antioxidant capacity (TAS), total oxidant capacity (TOS), and oxidative stress index (OSI)) in patients with epilepsy and to evaluate their relationship with each other. METHODS: The study included 60 patients with epilepsy and 35 healthy controls. The group of patients with epilepsy consisted of 21 patients with treatment-resistant epilepsy and 39 patients with well-controlled epilepsy. The patients with epilepsy were also classified as monotherapy and polytherapy group according to the number of antiepileptic drugs they used, and focal and generalized epilepsy group according to the seizure type. Serum IL-33, TAS, TOS and OSI levels were measured in the patients with epilepsy and the control group. RESULTS: The mean serum TAS level was significantly lower in the all patients with epilepsy group compared to the control group, and the mean serum IL-33, TOS, and OSI levels were significantly higher. The mean serum TOS and OSI levels were significantly lower and TAS levels were significantly higher in the patients with well-controlled epilepsy than the patients with treatment-resistant epilepsy. While there was a positive correlation between serum IL-33 and OSI levels in the all patients with epilepsy group, a negative correlation was shown between IL-33 and TAS levels. CONCLUSION: The IL-33/ST2 pathway may represent a new promising therapeutic strategy both for the treatment and the prevention of the disease.