Evaluation of the awareness of the physicians on negligence and abuse of the elderly patients admitted to emergency department

Introduction: With the increase in the population of the elderly, the negligence and abuse of the elderly (NAE) is increasing at a great pace. Although the rates of NAE in the elderly admitted to emergency depart- ment (ED) is more than the estimated rates, the diagnosis and reporting of such cases are extremely rare. The primary aim of the present study is to evaluate the NAE status in the elderly admitted to ED, the awareness in ED physicians, the attitudes towards these cases and the knowledge levels in this field.  Methods: An electronic questionnaire form that was used as the data collection tool consisted of 19 ques- tions and 2 sections. To call for participation, the questionnaires used in the study were shared with the ED physicians in an online manner between December 2017 and April 2018. The data were analyzed with the SPSS 23.0 Windows computer program with definitive statistics.  Results: A total of 69.4% of the participants faced NAE and 30% did not report this; 79.8% of the partic- ipants stated that they had received training in this field and 9% stated that there was a screening test for the abuse of the elderly. A statistically significant difference was determined between those who received course training in this field and those who received training during medicine faculty education and specialist training.  Conclusions: In this study, it was observed that the NAE rates were more than the estimated rates in the elderly admitted to ED. It was understood that ED physicians did not have adequate knowledge in this field. A new curriculum is needed for the training and education in this field. 

Co2 Storm Hysteresis in Karst Springs

Studying how the chemistry of karst spring water reacts to periods of increased discharge can provide insights into how these systems store and transmit water. Changes in the partial pressure of carbon dioxide (PCO2) in karst spring water during storm ev

Beyin Anevrizmalarının Cerrahi Tedavisinde Indocyanine Green Videoanjiyografi Kullanımı

Bu çalışmada, beyin anevrizması nedeniyle cerrahi tedavi uygulanan bir hasta grubunda İndosiyanin Yeşili Videoanjiyografi (ICG-VA) yönteminin sonuçlarının değerlendirilmesi amaçlanmıştır. Bu intraoperatif değerlendirme yönteminin güvenilirliğini saptamak için, ICG-VA bulguları postoperative anjiyografi ile karşılaştırılmıştır ve bu yöntemin faydaları ve kısıtlılıkları tartışılmıştır. Bu çalışmaya, 75 anevrizma saptanan altmış bir ardışık hasta dahil edilmiştir. Anevrizmanın kliplenmesini takiben; anevrizmayı, ana arterleri ve perforan arterleri göz lemlemek için intravenöz yoldan ICG uygulandı. Ameliyat sonrasında tüm hastalara taburculuk öncesi anjiyografi yapıldı. Anevrizmala rın %86,6'sında, ICG-VA tatmin edici klipleme sağlandığını gösterdi ve ICG-VA bulguları postoperatif anjiyografi ile uyumluydu. Anevriz maların %6.6'sında, anormal ICG-VA bulguları saptandı ve kliplerin değiştirilmesi veya düzeltilmesi gerekli oldu. Anevrizmaların bir di ğer % 6.6'sında ise, ICG-VA herhangi bir patolojik bulgu göstermezken postoperatif anjiyografide anormal bulgular saptandı. ICG-VA ameliyat esnasında kan akımının değerlendirmesinde altın standart yöntem olan intraoperatif anjiyografinin yerini almamakla birlikte, beyin anevrizmalarının cerrahi tedavisinde hasta güvenliğine büyük katkıda bulunmaktadır. ICG-VA, iyi görüntü kalitesiyle cerrahi alanın gerçek zamanlı değerlendirilmesini mümkün kılmaktadır. İşlemi gerçekleştirmek ve değerlendirmek kolaydır. Bu teknik, anevrizma cerrahisinin standart bir uygulaması olarak değerlendirilmelidir.This study evaluates results of Indocyanine Green Videoangiography (ICG-VA) in a patient group with intracerebral aneurysms. To assess reliability of this technique, ICG-VA findings were compared with postoperative cerebral angiography. Furthermore, benefits and limitations of this intraoperative evaluation method were discussed. This study includes 75 aneurysms in 61 consecutive patients. Following clip ligation of the aneurysm, ICG was administrated intravenously to observe the aneurysm, parent arteries, and perforating arteries. All patients under went postoperative angiography before discharge. In 86.6% of aneurysms, ICG-VA confirmed satisfactory clip application and was concor dant with postoperative angiography. In 6.6% of aneurysms, ICG-VA showed pathological findings intraoperatively leading to readjustment of clips immediately. In another 6.6% of aneurysms, ICG-VA did not reveal any pathological findings intraoperatively while postoperative angiography was not normal in these cases. ICG-VA cannot replace the intraoperative angiography yet as the gold standard method of int raoperative blood assessment. However, this technique adds greatly to the safety of the surgical treatment of intracranial aneurysms. ICG-VA promoted real time assessment of the surgical field with good image quality. It is easy to perform and evaluate the procedure. This technique has the potential to be considered as a standard step of this surgical intervention

Eksiklik sendromu olan ve olmayan şizofreni hastalarında gri madde değişiklikleri

Objectives: Reduced gray matter volume is a frequently reported finding in brain imaging studies performed with schizophrenia patients. Some studies suggest a probable link between the negative symptoms of schizophrenia and gray matter loss; however, some of the negative symptoms observed in schizophrenia patients are not primarily linked to the core of schizophrenia. This study aimed to compare gray matter volumes in patients with primary negative symptoms (deficit schizophrenia [DS]), non-DS (NDS) patients, and healthy controls. Materials and Methods: The study included 11 DS patients, 18 non-DS patients, and 17 healthy controls. Magnetic resonance imaging (MRI) was performed using a 1.5 Tesla MR unit. The Schedule for Deficit Syndrome (SDS) was used to determine which patients were DS and non-DS. MR images were compared using voxel-based morphometry (VBM) analysis. Results: Contrary to expectations, no evidence to support less gray matter in DS patients than in NDS patients was observed. Furthermore, NDS patients had less gray matter volume in several brain regions (frontal and temporal cortices) than did the DS patients. All patients had perisylvian gray matter volume deficits, though the NDS patients had more widespread volume deficiencies. Conclusion: No evidence to support the hypothesis that DS patients have less gray matter volume than those of NDS patients was observed. On the contrary, DS patients had more gray matter volume in some regions; the differences observed in gray matter volume in these brain regions between the 2 patient groups may be responsible for the differences in their clinical manifestations.Amaç: Şizofreni hastalarında gerçekleştirilen beyin görüntüleme çalışmalarında gri madde azalması sıklıkla bildirilen bir bulgudur. Bazı çalışmalarda şizofrenide görülen negatif belirtiler ile gri madde kaybı arasında ilişki olduğunu düşündüren sonuçlar elde edilmiştir. Bununla birlikte, hastalarda gözlenen negatif bulguların önemli bir kısmı hastalık dışı nedenler ile ortaya çıkmaktadır. Bu çalışmada primer negatif belirtileri olan [eksiklik sendromu (ES)] hastalardaki gri madde değişiklikleri, kontrol grubu ve eksiklik sendromu olmayan hastalar ile karşılaştırılmıştır. Yöntem: Çalışmaya ES olan 11 ve ES olmayan 18 şizofreni hastası ile 17 sağlıklı gönüllü alınmıştır. Olguların manyetik rezonans (MR) görüntüleri 1,5 T gücündeki cihaz ile elde edilmiştir. Hastaların ES olup olmadıklarına “Şizofrenide Eksiklik Sendromu Çizelgesi”ne (ŞESÇ) göre karar verilmiştir. Görüntüler voksel tabanlı morfometri (VBM) analizi ile karşılaştırılmıştır. Bulgular: Beklenenin aksine ES gösteren hastalarda, diğer şizofreni hastalarına göre daha az gri madde lehine bulgu elde edilememiştir Dahası, ES olmayan şizofreni hastalarının bazı beyin bölgelerinde (frontal ve temporal korteks) ES olan hastalara göre daha az gri madde hacmine sahip oldukları saptanmıştır. Tüm şizofreni hastalarının gri madde eksikliklerinin özellikle perisilviyan bölgede yoğunlaştığı izlenmekle birlikte, ES olmayan hastaların gri madde eksikliklerinin tüm kortekste daha yaygın olduğu görülmüştür.. Sonuç: ES olan hastaların daha yaygın gri madde eksikliklerine sahip olduğuna ilişkin yaygın görüşü doğrulayacak yeterli kanıt bulunmamaktadır. Aksine belirli bazı beyin bölgelerinde ES olmayan hastaların daha az gri madde hacmine sahip oldukları görülmüştür. İki hasta grubu arasındaki hacim farkının gözlendiği alanların, iki sendrom arasındaki klinik tablonun farkından sorumlu olabileceği düşünülmüştür

ARTICLE IN PRESS Gray Matter Changes in Patients with Deficit Schizophrenia and Non-Deficit Schizophrenia 2

Objectives: Reduced gray matter volume is a frequently reported finding in brain imaging studies performed with schizophrenia patients. Some studies suggest a probable link between the negative symptoms of schizophrenia and gray matter loss; however, some of the negative symptoms observed in schizophrenia patients are not primarily linked to the core of schizophrenia. This study aimed to compare gray matter volumes in patients with primary negative symptoms (deficit schizophrenia [DS]), non-DS (NDS) patients, and healthy controls. Materials and Methods: The study included 11 DS patients, 18 non-DS patients, and 17 healthy controls. Magnetic resonance imaging (MRI) was performed using a 1.5 Tesla MR unit. The Schedule for Deficit Syndrome (SDS) was used to determine which patients were DS and non-DS. MR images were compared using voxel-based morphometry (VBM) analysis. Results: Contrary to expectations, no evidence to support less gray matter in DS patients than in NDS patients was observed. Furthermore, NDS patients had less gray matter volume in several brain regions (frontal and temporal cortices) than did the DS patients. All patients had perisylvian gray matter volume deficits, though the NDS patients had more widespread volume deficiencies. Conclusion: No evidence to support the hypothesis that DS patients have less gray matter volume than those of NDS patients was observed. On the contrary, DS patients had more gray matter volume in some regions; the differences observed in gray matter volume in these brain regions between the 2 patient groups may be responsible for the differences in their clinical manifestations