Determining Risk Factors of Epilepsy in Children with Cerebral Palsy: A Retrospective Study

Aim: The aim of this study is to determine the risk factors of epilepsy development in children with cerebral palsy. Materials and Methods: Data of 234 cerebral palsy patients treated at Ege University Pediatrics Department, Child Neurology Division between January 2008 and December 2015 were evaluated retrospectively. All patients were classified into two groups; Group I: cerebral palsy without epilepsy (n=116) and Group II: cerebral palsy with epilepsy (n=118). The clinical and laboratory findings of the groups were compared to each other, a p value of less than 0.05 was considered as statistically significant. Results: There was no significant difference between the two groups in terms of gender, gestastional age, birth type, birth weight, risk factors for cerebral palsy development (pre-/peri-/postnatal), duration of neonatal intensive care stay and the need for mechanical ventilation (p>0.05). The risk factors of epilepsy were determined as the following; the presence of neonatal convulsions, focal clonic and generalized tonic neonatal seizures, an abnormal baseline rhythm on neonatal electroencephalography (EEG), discharge from neonatal intensive care unit with at least one antiepileptic drug, spastic bilateral (tetraplegic) cerebral palsy, epileptic activity on the sixth month EEG, abnormal cranial magnetic resonance imaging findings, mental retardation, microcephaly and visual problems. Conclusion: Epilepsy is a common problem in children with cerebral palsy. Therefore, cases of cerebral palsy, especially those with the determined risk factors should be closely monitored for epilepsy in order to ensure a timely diagnosis and proper treatment

COMMUNICATION SKILLS AND PERCEIVED STRESS OF NURSING STUDENTS DURING FIRST CLINICAL EXPERIENCE

Aim: To evaluate the relationship between communication skills and perceived stress of nursing students duringthe first clinical experience.Methods: The cross-sectional descriptive study was conducted with 225 nursing students over the period ofFebruary 2018 and June 2018. The students compared the following criteria: willing to participate in the study,being in first clinical experience. The Communication Skills Scale, the Perceived Stress Scale, and the IndividualIdentification Form were used for collecting data.Findings: It showed that nursing students’ level of communication skills was high and the level of perceived stresswas moderate. There was a weak positive correlation between nursing students’ communication skills andperceived stress.Conclusion: Considering that the stress level of students is moderate and the communication skills level is high,this result can be considered as a positive outcome. Effective communication skills are needed to minimize thehigh stress experienced in clinical practice

TARİHSEL SÜREÇ İÇİNDE HEMŞİRELİK SÜRECİ VE BAKIM PLANLARININ GELİŞİMİ

Sistematik ve bireye özgü bakım yöntemi olan hemşirelik süreci, hasta ve/veya sağlıklı bireyin, grupların ve/veyaailelerin sağlık bakım sorunlarının ve/veya sağlık bakım ihtiyaçlarının tanılaması, gerekli hemşirelikgirişimlerinin planlanması, uygulanması ve sonuçların değerlendirilmesi aşamalarından oluşmaktadır. Etkili birşekilde uygulandığında profesyonel hemşireliğe sağladığı önemli katkılar bulunmaktadır. Hemşirelik sürecinin ilkaşaması olan tanılama eylemi, Florence Nightingale ve meslektaşları tarafından gerçekleştirilen, modernhemşirelikle aynı yaşlarda olan bir olgudur. Hemşirelik süreci kavramı ilk kez 1955 yılında hemşirelerin neleryapması gerektiğini belirlemek amacıyla Lydia Hall tarafından kullanılmıştır. 1991 yılında Amerikan HemşirelerBirliği (American Nurses Association; ANA) Uygulama Standartlarının son versiyonunda hasta sonucununbelirlenmesi adımı eklenmiştir. Hemşirelik sürecinin Türkiye’deki gelişimi incelendiğinde; hemşirelik sürecininilk olarak Vehbi Koç Vakfı tarafından “Fundamentals of Nursing” kitabının çevirisiyle Türk literatürüne girdiğigörülmektedir. İçerisinde hemşirelerin yetki, görev ve sorumlulukları bulunan ve 2010 yılında yayınlananHemşirelik Yönetmeliği’nde hemşirelik sürecinin amacı ve yasal olarak hemşirelik sürecinin kullanması gerekliliğivurgulanmaktadır. Son yıllarda hemşirelik sürecinin gelişimi ile birlikte bakım planlarının uygulama şekilleri dedeğişim ve gelişim göstermiştir. Hemşirelik sürecinin oluşturulması ve sürecin görünür hale getirilmesinde halenpopülerliğini koruyan hemşirelik bakım planlarının yararları düşünüldüğünde kullanımı teşvik edilmelidir

The Status of Protecting and Maintaining Patient Privacy of Intern Nurses and Affecting Factors

Aim:The aim of this study was to determine the status of intern nurses to protect and maintain patient privacy and affecting factors. Methods:The study planned as cross-sectional study and conducted between December 2017 and February 2018 at a nursing faculty in Turkey. In the collection of data, 252 intern nurses were reached. The data of the study were gathered by questionnaire method using “Individual Identification Form,” Intern Nursing Students’ Information Form Related to Privacy,” and “Patient Privacy Scale”. In statistical analysis, frequency, mean and standard deviation, Kruskal–Wallis and Mann–Whitney U-test were used. Results: Of the intern nurses, 82.5% were female and their ages were in the range of 21-24 years. The mean score of the Patient Privacy Scale of them was 4.56 ± 0.40. In the subscales, “physical privacy” displayed the highest mean score (4.67 ± 0.47), while “gender-related privacy” was the lowest (4.41 ± 0.51). In addition, it was found that there was a statistically significant relationship between the variables of Patient Privacy Scale total score, gender, hospitalization experience, having knowledge about privacy, believing privacy was always necessary and meeting the privacy needs of their patients variables (P .05). Conclusion: It was determined that the intern nurses’ approaches to protect and maintain patient privacy were found to be positive. It should be observed whether this is reflected in care during clinical practice

Prognostic factors for survival in adult patients with grade II glial tumors

Aim: To investigate survival results of patients with low grade gliomas (LGGs) and to evaluate the predictive role of clinico-pathologic prognostic factors on survival. Material and Methods: Between 2003 and 2014, the adult patients with Grade II glial tumors were evaluated retrospectively. Several variables were investigated to find prognostic factors related with the overall survival (OS) and progression-free survival (PFS). Results: This study involved in 124 patients with median 40 (range; 6-132) months follow up. The average OS for the all patients was 7.8 years. 2-, 5- and 10- year OS ratios were 91%, 73% and 55%, respectively. Patients with low pignatti risk score had a longer OS than high pignatti risk score (p=0.01). Patients with seizure had a better OS (p=0.03). Patients with biopsy/partial resection had apoorer OS (p=0.02). Patients with residue after initial surgery had a worse OS (p=0.03). If the patients had recurrence or progression, the patients had poorer OS (p=0.01). Tumor with malignant transformation (p=0.01) and glioblastoma subtype after second surgery (p=0.003) had a poorer OS. The Pignatti risk score and seizure were the independent prognostic factors for PFS. Conclusion: The extent of surgery and recurrence or progression of Grade II glioma were the independent prognostic factors for OS. The Pignatti risk score and seizure were the independent prognostic factors for PFS

Prognostic Factors for Survival in Adult Patients With Grade II Glial Tumors

Aim: To investigate survival results of patients with low grade gliomas (LGGs) and to evaluate the predictive role of clinico-pathologic prognostic factors on survival.Material and Methods: Between 2003 and 2014, the adult patients with Grade II glial tumors were evaluated retrospectively. Several variables were investigated to find prognostic factors related with the overall survival (OS) and progression-free survival (PFS).Results: This study involved in 124 patients with median 40 months follow up. The average OS for the all patients was 7.8 years. 2-, 5- and 10- year OS ratios were 91%, 73% and 55%, respectively. Patients with low pignatti risk score had a longer OS than high pignatti risk score (p0.01). Patients with seizure had a better OS (p0.03). Patients with biopsy/partial resection had a poorer OS (p0.02). Patients with residue after initial surgery had a worse OS (p0.03). If the patients had recurrence or progression, the patients had poorer OS (p0.01). Tumor with malignant transformation (p0.01) and glioblastoma subtype after second surgery (p0.003) had a poorer OS. The Pignatti risk score and seizure were the independent prognostic factors for PFS.Conclusion: The extent of surgery and recurrence or progression of Grade II glioma were the independent prognostic factors for OS. The Pignatti risk score and seizure were the independent prognostic factors for PFS

Five-Year Survival Outcomes of Breast Cancer and Prognostic Factors. A Single Institution Experience

Kliniğimizde tedavi edilen olgu serisini retrospektif olarak inceleyerek 5 yıllık sağkalım sonuçlarını ve sağkalımı etkileyen prognostik parametreleri saptamaktır. Meme kanseri tanısıyla başvuran ve kliniğimizin rutin meme prosedürüne göre küratif olarak tedavi olmuş olgu verileri incelenmiştir. Tüm olgular üç boyutlu konformal RT tekniği ile göğüs duvarı veya meme dokusuna karşılıklı paralel tanjansiyel alanlar kullanılarak günlük 2 Gy fraksiyon dozuyla haftada 5 gün olacak şekilde tedavi edilmiştir. Rejyonel lenf nodu bölgesinin tedavi edilmesi gereken durumlarda ise supraklavikuler fossa ışınlaması da tedaviye eklenmiştir. Olgulara sıklıkla antrasiklin bazlı kemoterapi rejimleri uygulanmış olup, östrojen reseptörü pozitif olan olgular hormon tedavisi, Her-2 reseptör pozitif olgular da trastuzumab tedavisi almıştır. Çalışmanın birincil sonlanım noktaları genel sağkalım (GS) ve hastalıksız sağkalım (HS) idi. İkincil sonlanım noktası ise sağkalım süreleri üzerine etkili olan prognostik faktörleri saptamak idi. Tüm istatistiksel analizler SPSS (Statistical Package for Social Sciences) 13 versiyonu kullanılarak yapılmıştır. 11.02.2010- 01.05.2016 tarihleri arasında kliniğimize başvuran toplam 559 meme kanseri olgusu değerlendirilmiştir. 2 ve 5 yıllık GS oranları sırasıyla %97 ve %84; 2 ve 5 yıllık HS oranları sırasıyla %97 ve %71 olarak bulunmuştur. Çok değişkenli analizlerde, 70 yaş, triple (-) olmak, T3-4 evre hastalığa sahip olmak, N2-3 nodal evre hastalığa sahip olmak ve metastaz yada lokal- bölgesel nüks olması GS’ yi olumsuz etkileyen bağımsız prognostik faktörler olarak bulunurken; N2-3 nodal hastalığa sahip olmak ve triple (-) olmak HS’ yi olumsuz etkileyen faktörler olarak saptanmıştır. Meme kanseri dünya genelinde kadınlar arasında görülen en sık kanser türü olup insidansı artmasına rağmen hastalığa bağlı mortalite oranları zamanla düşmeye başlamıştır. Güncel tedavi modaliteleri ışığında prognostik faktörlerin bilinmesi hem en doğru tedavi modalitesinin seçilmesi hem de uygulanan tedavi modalitesine alınacak yanıtın öngörülebilmesi açısından önemlidir.To evaluate the five year survival outcomes of breast cancer patients treated at our department and to assess the prognostic factors that affect survival parameters. All patients underwent our department’s routine procedure for breast cancer. All patients received RT to the breast or chest wall using 3D conformal technique with 2 Gy fraction doses, five days a week with two opposite tangential fields. If necessary, ipsilateral supraclavicular fossa field was added to the treatment field . Anthracycline -based chemotherapy was primarily used, patients with estrogen receptor- positive disease received hormonal therapy and patients with Her- 2 receptor -positive disease received trastuzumab. The primary end points of this study were to evaluate the overall survival (OS) and the disease-free survival (DFS) of the patients. The secondary end points of this study were to assess the prognostic factors that affect the survival outcomes. Statistical analysis were carried out using SPSS Statistic program version 13. Between 11.02.2010 and 01.05.2016, 559 patients with breast cancer who had been irradiated postoperatively were included in this retrospective study. 2 and 5 year OS rates were 97% and 84%; 2 and 5 year DFS rates were 97% and 71%, respectively. According to multivariate analysis, 70 year, to have triple (-) hormonal status, to have T3-4 disease, to have N2-3 nodal stage and to have locoregional recurrence or distant metastasis were the independent prognostic factors that affect OS. Also, to have N2-3 nodal stage and to have triple (-) hormonal status were independent prognostic factors that affect DFS. Breast cancer is the most common cancer among women. Its incidence has been increasing but mortality has been decreasing in the last 10-15 years . In the light of current treatment modalities, to know the prognostic factors that affect survival outcomes is very important for both choosing the most appropriate treatment modality and the prediciton of treatment response

De Novo CHRNE Mutation: Congenital Myasthenic Syndrome

Congenital myasthenic syndromes (CMS) are neuromuscular hereditary diseases with the symptoms of fatigue, weakness, ptosis, ophthalmoparesis and respiratory problems. This disease group is classified as CMS originating from the presynaptic region, synaptic gap and postsynaptic region according to the origin of the neuromuscular junction. Most of these patients are affected by receptor defects originating from the postsynaptic gap. Here, we present a case who was thirteen years old and had a CHRNE genotype p.Y124 *(c.372C> G) homozygous mutation, which is associated with weakness, low voice, ophthalmoparesis and frequent respiratory infection since birth. Our patient has been diagnosed with non-kinetic AChR deficiency and the case is important with the detection of a new mutation