Comparison of Cognitive Impairment between Patients having Epilepsy and Psychogenic Nonepileptic Seizures

Kurt, Pınar (Arel Author)Amaç: Bu çalışmanın amacı hem epilepsi hastalarında, hem de psikojen nonepileptik nöbet (PNEN) geçiren hastalarda nöbet öncesi ve nöbet sonrası erken dönemde yapılan nöropsikolojik testlerle kognitif etkilenmeyi değerlendirmektir. Yöntem: Çalışmaya dahil edilen hastalara seçilmiş nörokognitif testler uygulanmıştır. Monitorizasyonda tipik nöbet gözlendikten ve elektroensefalografi (EEG) aktivitesi normale döndükten sonra 24 saat içerisinde hastalara daha önce uygulanmış olan nörokognitif testler tekrarlanmıştır. Sağlıklı kontrol grubuna da bazal nörokognitif testler uygulanmış, ikinci nörokognitif değerlendirme 24-96 saat içerisinde yapılmıştır. Bulgular: Bazal kognitif değerlendirmede PNEN'i olan hasta grubunda, sözel bellek öğrenme puanı ve stroop testi enterferans süresi kontrollere oranla anlamlı olarak daha kötü saptandı. Epilepsisi olan hastalarda yapılan bazal kognitif testlerde ise kontrollere göre, sözel bellek öğrenme puanı, uzun süreli bellek ve toplam tanıma test puanları anlamlı olarak daha düşük saptandı. Tekrarlanan kognitif testler sonrasında, PNEN'i olan hasta grubunda sözel kategorik akıcılık puanında anlamlı yükselme saptandı. Epilepsisi olan grupta anlamlı fark saptanmadı. Kontrol grubu içerisinde ise Stroop enterferans süresinde anlamlı kısalma olduğu saptandı, ancak benzer değişim epilepsi hastalarında ve PNEN'i olan hasta grubunda gözlenmedi. Sonuç: Değerlendirilen epilepsi hastalarında bellek sorunları görece ön planda iken, PNEN'i olan hastalarda dikkat ve yürütücü işlev sorunları daha baskın gibi gözükmektedir. Bu bulgular olasılıkla hastalık süresi, duygudurum bozuklukları ve belirli ilaç kullanımları gibi pek çok faktörle etkileş- mektedir. Tüm hasta grubunda nöbet sonrası erken dönemde dikkat ve yürütücü işlevlerde bir bozulma ortaya konamamıştır.Introduction: The aim of this study was to evaluate cognitive impairment in patients having epilepsy or psychogenic nonepileptic seizures (PNESs) using selected neuropsychological tests at different time periods related to the seizure. Methods: In this study, selected neurocognitive tests were administered to the patients. Within 24 h, the previously applied neurocognitive tests were repeated within 24 h following the observation of typical seizures when monitoring and normalizing electroencephalography (EEG) activity. Basal neurocognitive tests were also administered to the healthy control group, and repeat neurocognitive evaluation was performed within 24-96 h. Results: The basal neurocognitive evaluation revealed that verbal learning and memory scores as well as Stroop test interference time were significantly lower in the PNES group compared with those in the controls. In the basal cognitive tests administered to the patients with epilepsy, verbal learning and memory scores, long-term memory, and total recognition test scores were significantly lower than those of the controls. Following the repeat cognitive tests, significant progress was found in the verbal categorical fluency score of the PNES group. No significant difference was determined in the epilepsy group. Significant contraction was determined in the Stroop interference time in the control group, but no similar change was recorded in the epilepsy or PNES groups. Conclusion: While memory problems seemed to be most prominent in the assessed patients with epilepsy, attention and executive function problems were more dominant in the patients with PNESs. These findings are probably related to numerous factors such duration of disease, mood disorders, and specific drug use. No deterioration in attention and executive functions was reported in the early post-seizure period in either patient group

Efficacy of colistin and non-colistin monotherapies in multi-drug resistant acinetobacter baumannii bacteremia/sepsis

Objective: This retrospective study aimed to investigate the efficacies of colistin and non-colistin monotherapies in multi-drug resistant Acinetobacter baumannii bacteremia (MDR-AB). Materials and methods: Cases with MDR-AB from 27 tertiary-referral hospitals between January 2009 and December 2012 were included. Patients' data that were on either colistin monotherapy (CM) or non-colistin monotherapy (NCM) were compared. Mortality on Day 14 was the primary endpoint, whereas microbiological eradication and clinical outcome were the secondary ones. Results: Eighty-four cases were included in the study with 36 being in the CM group and 48 in the NCM group. Thirty-eight (45.2%) cases were male and the mean age was 60.2 years. The mean durations of pre-MDR-AB hospital stay and intensive care unit stay were 25.8 days and 20.9 days, respectively. All of the cases had fever (>38°C). The mean Pitt bacteremia score (PBS) of the patients was calculated as 6.8, APACHE 2 score as 18.9 and the Charlson co-morbidity index (CCI) as 3.7 (CM: 3.6 vs. NCM: 3.9). Twenty (55.6%) cases in the CM group and 26 cases in the NCM group (54.2%) (p=0.81) died; 9 cases in the CM group (25%) and 16 cases in the NCM group (33.3%) had treatment failure (P=0.55). Bacteriological eradication was achieved in 20 (55.6%) cases in the CM group and in 36 cases (75%) in the NCM group (P=0.061). Conclusions: No significant difference could be identified between the colistin monotherapy and non-colistin monotherapy options in MDR-AB cases with respect to the results of efficacy and 14-day mortality

Efficacy of colistin and non-colistin monotherapies in multi-drug resistant acinetobacter baumannii bacteremia/sepsis

Objective: This retrospective study aimed to investigate the efficacies of colistin and non-colistin monotherapies in multi-drug resistant Acinetobacter baumannii bacteremia (MDR-AB). Materials and methods: Cases with MDR-AB from 27 tertiary-referral hospitals between January 2009 and December 2012 were included. Patients' data that were on either colistin monotherapy (CM) or non-colistin monotherapy (NCM) were compared. Mortality on Day 14 was the primary endpoint, whereas microbiological eradication and clinical outcome were the secondary ones. Results: Eighty-four cases were included in the study with 36 being in the CM group and 48 in the NCM group. Thirty-eight (45.2%) cases were male and the mean age was 60.2 years. The mean durations of pre-MDR-AB hospital stay and intensive care unit stay were 25.8 days and 20.9 days, respectively. All of the cases had fever (>38°C). The mean Pitt bacteremia score (PBS) of the patients was calculated as 6.8, APACHE 2 score as 18.9 and the Charlson co-morbidity index (CCI) as 3.7 (CM: 3.6 vs. NCM: 3.9). Twenty (55.6%) cases in the CM group and 26 cases in the NCM group (54.2%) (p=0.81) died; 9 cases in the CM group (25%) and 16 cases in the NCM group (33.3%) had treatment failure (P=0.55). Bacteriological eradication was achieved in 20 (55.6%) cases in the CM group and in 36 cases (75%) in the NCM group (P=0.061). Conclusions: No significant difference could be identified between the colistin monotherapy and non-colistin monotherapy options in MDR-AB cases with respect to the results of efficacy and 14-day mortality

Miego apnėja tarp sergančiųjų išemine širdies liga: dažnis, susiję veiksniai, sąsajos su kairiojo skilvelio morfometrijos ir funkcijos rodikliais

The purpose of the study. The purpose of this cross sectional study was to determine prevalence of sleep apnea, characteristics, association with traditional CAD risk factors and to investigate association between sleep apnea and alteration in left ven-tricular morphometry and function in CAD patients. Objectives of the study. 1. To cross-sectionally investigate prevalence of sleep apnea and differ-ences in clinical and polysomnographic characteristics in CAD pa-tients with and without sleep apnea. 2. To explore whether routine clinical features from the study of patients with CAD could predict the presence of sleep apnea by two thresholds for diagnosing (apnea-hyponea index ≥5 and ≥15). 3. To determine whether there are differences in risk factors for the pres-ence of sleep apnea between men and women with CAD. 4. To cross-sectionally investigate the association between sleep apnea and left ventricular morphometry in CAD patients. 5. To identify association between left ventricular diastolic function pa rameters and sleep apnea in CAD patients with left ventricular ejec-tion fraction ≥50%. Statements of the hypotheses. We hypothesised, that in CAD patients: 1. Sleep apnea is common in CAD patients with no previous sleep apnea diagnosis. The traditional CAD risk factors such as age, male gender, obesity and hypertension, is more prevalent among patients with sleep apnea compared with patients without sleep apnea. Significant small correlations between some polisomnographic parameters and the severity of sleep apnea could be found. 2. Using the same set of potential clinical confounders, the prognostic factors of the presence of sleep apnea differ when adapting the two cutoffs of apnea-hypopnea index for sleep apnea diagnosis. 3. The risk factors for the presence of SA in women differ from those in men. 4. Mild to moderate sleep apnea is cross-sectionally [...]