1.Determining of migraine prognosis using latent growth mixture models.
Bahar TASDELEN ; Aynur OZGE ; Hakan KALEAGASI ; Semra ERDOGAN ; Tufan MENGI
Chinese Medical Journal 2011;124(7):1044-1049
BACKGROUNDThis paper presents a retrospective study to classify patients into subtypes of the treatment according to baseline and longitudinally observed values considering heterogenity in migraine prognosis. In the classical prospective clinical studies, participants are classified with respect to baseline status and followed within a certain time period. However, latent growth mixture model is the most suitable method, which considers the population heterogenity and is not affected drop-outs if they are missing at random. Hence, we planned this comprehensive study to identify prognostic factors in migraine.
METHODSThe study data have been based on a 10-year computer-based follow-up data of Mersin University Headache Outpatient Department. The developmental trajectories within subgroups were described for the severity, frequency, and duration of headache separately and the probabilities of each subgroup were estimated by using latent growth mixture models. SAS PROC TRAJ procedures, semiparametric and group-based mixture modeling approach, were applied to define the developmental trajectories.
RESULTSWhile the three-group model for the severity (mild, moderate, severe) and frequency (low, medium, high) of headache appeared to be appropriate, the four-group model for the duration (low, medium, high, extremely high) was more suitable. The severity of headache increased in the patients with nausea, vomiting, photophobia and phonophobia. The frequency of headache was especially related with increasing age and unilateral pain. Nausea and photophobia were also related with headache duration.
CONCLUSIONSNausea, vomiting and photophobia were the most significant factors to identify developmental trajectories. The remission time was not the same for the severity, frequency, and duration of headache.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Hyperacusis ; physiopathology ; Middle Aged ; Migraine Disorders ; pathology ; physiopathology ; Nausea ; physiopathology ; Photophobia ; physiopathology ; Retrospective Studies ; Vomiting ; physiopathology ; Young Adult
2.Total thyroidectomy is safer with identification of recurrent laryngeal nerve.
Hakan CANBAZ ; Musa DIRLIK ; Tahsin COLAK ; Koray OCAL ; Tamer AKCA ; Oner BILGIN ; Bahar TASDELEN ; Suha AYDIN
Journal of Zhejiang University. Science. B 2008;9(6):482-488
OBJECTIVETo investigate the effect of recurrent laryngeal nerve (RLN) identification on the complications after total thyroidectomy and lobectomy.
METHODSTotal 134 consecutive patients undergoing total thyroidectomy or thyroid lobectomy from January 2003 to November 2004 were investigated retrospectively. Patients were divided into two groups: RLN identified (Group A) or not (Group B). The two groups were compared for RLN injury and hypocalcaemia.
RESULTSThe numbers of patients and nerves at risk were 71 and 129 in Group A, and 63 and 121 in Group B, respectively. RLN injury in Group A (0) was significantly lower than that in Group B (5 [7.9%]) patients, 7 [5.8%] nerves) for the numbers of patients (P=0.016) and nerves at risk (P=0.006). Temporary hypocalcaemia was significantly higher in Group A than in Group B (14 [24.1%] vs 6 [10.3%], P=0.049). Permanent complications in Group B were significantly higher than those in Group A (13 [20.6%] vs 4 [5.6%], P=0.009).
CONCLUSIONRLN injury was prevented and permanent complications were decreased by identifying the whole course and branches of the recurrent laryngeal nerve during total thyroidectomy.
Adult ; Dissection ; adverse effects ; methods ; Female ; Goiter ; surgery ; Goiter, Nodular ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; prevention & control ; Recurrent Laryngeal Nerve ; anatomy & histology ; Recurrent Laryngeal Nerve Injuries ; Retrospective Studies ; Risk Factors ; Safety ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; adverse effects ; methods