6 research outputs found
Our experience of spinal dural arteriovenous fistula: 4 case reports
Spinal dural arteriovenous fistula, which is caused by the low flow shunts between dural arteries and the perimedullary venous system shows progressive myelopathy signs. It is usually found in the thoracic region. It is vital to accurately make differential diagnosis since the disease may cause irreversible injury. In this case report we aimed to discuss four cases of spinal arteriovenous fistula that showed different outcomes
Health-Related Quality of Life in Patients with Epilepsy
Objectives:This study aimed to evaluate health-related quality of life in patients with epilepsy and to investigate the role of sociodemographic attributes and clinical features.Methods:Two hundred five patients diagnosed with epilepsy and under the follow-up of epilepsy outpatient clinics of our tertiary center were enrolled. Gender, age, age of epilepsy onset, disease duration, seizure type, epilepsy etiology, frequency of seizures, anti-seizure drugs, electroencephalography, and magnetic resonance imaging findings were noted. The Short Form-36, valid and reliable in our country, was used to assess health-related quality of life. The Short Form-36 physical and mental scores were calculated.Results:All Short Form-36 subscores of patients were low when compared to the normative data of our country. Some physical and mental health scores of women with epilepsy were lower than the scores of men with epilepsy. All Short Form-36 subscores of patients under polytherapy were lower than the ones under monotherapy. Some quality of life scores were negatively correlated with disease duration; yet the range of age, age of epilepsy onset, seizure type, etiology of epilepsy, cranial magnetic resonance imaging, and electroencephalography findings were not significantly correlated with Short Form-36 scores.This study revealed that health-related quality of life of patients with epilepsy was lower than that of healthy individuals. It should be noted that Conclusions:women with epilepsy, patients with longer disease duration, patients suffering from frequent seizures, and the ones under polytherapy could have a lower quality of life. Patients with epilepsy should be supported in means of quality of life and modifiable factors
Türkiye'de inme hastalarında atrial fibrilasyon ve yönetimi: Nörotek Çalışması gerçek hayat verileri (S-011)
Gastrostomy in hospitalized patients with acute stroke: "NoroTek" Turkey point prevalence study subgroup analysis
Objective: Nutritional status assessment, dysphagia evaluation and enteral feeding decision are important determinants of prognosis in acute neurovascular
diseases.
Materials and Methods: NöroTek is a point prevalence study conducted with the participation of 87 hospitals spread across all health sub regions of Turkey
conducted on 10-May-2018 (World Stroke Awareness Day). A total of 972 hospitalized neurovascular patients [female: 53%, age: 69±14; acute ischemic stroke
in 845; intracerebral hematoma (ICH) in 119 and post-resuscitation encephalopathy (PRE) in 8] with complete data were included in this sub-study.
Results: Gastrostomy was inserted in 10.7% of the patients with ischemic stroke, 10.1% of the patients with ICH and in 50% of the patients with PRE.
Independent predictors of percutaneous endoscopic gastrostomy (PEG) administration were The National Institutes of Health Stroke Scale score at admission [exp
(β): 1.09 95% confidence interval (CI): 1.05-1.14, per point] in ischemic stroke; and mechanical ventilation in ischemic [exp (β): 6.18 (95% CI: 3.16-12.09)] and
hemorrhagic strokes [exp (β): 26.48 (95% CI: 1.36-515.8)]. PEG was found to be a significant negative indicator of favorable (modified Rankin’s scale score 0-2)
functional outcome [exp (β): 0.032 (95% CI: 0.004-0.251)] but not of in-hospital mortality [exp (β): 1.731 (95% CI: 0.785-3.829)]. Nutritional and swallowing
assessments were performed in approximately two-thirds of patients. Of the nutritional assessments 69% and 76% of dysphagia assessments were completed
within the first 2 days. Tube feeding was performed in 39% of the patients. In 83.5% of them, tube was inserted in the first 2 days; 28% of the patients with
feeding tube had PEG later.
Conclusion: The NöroTek study provided the first reliable and large-scale data on key quality metrics of nutrition practice in acute stroke in Turkey. In terms
of being economical and accurate it makes sense to use the point prevalence method.Amaç: Akut nörovasküler hastalıklarda nütrisyonel durum ve disfaji değerlendirmesi ve enteral beslenme kararı önemli prognoz belirleyicilerindendir.
Gereç ve Yöntem: NöroTek, 10 Mayıs 2018’de (Dünya İnme Farkındalık Günü) Türkiye’nin tüm sağlık alt bölgelerine yayılmış 87 hastanenin katılımıyla
gerçekleştirilen bir nokta prevalans çalışmasıdır. Hastanede yatan ve bu alt çalışma için toplanan verisi tam olan toplam 972 nörovasküler hasta (kadın: %53, yaş:
69±14 yıl; 845’i akut iskemik inme; 119’u intraserebral hematom ve 8’i post-resüsitasyon ensefalopatisi) analiz edildi. Bulgular: Gastrostomi iskemik inmeli hastaların %10,7, intraserebral kanamalıların %10,1 ve post-resusitasyon ensefalopatisi olanların %50’sine uygulanmıştır.
Perkütan endoskopik gastrostomi (PEG) gereksiniminin bağımsız belirleyicileri, iskemik inme grubunda kabul NIHSS [exp (β): 1,09, %95 güven aralığı (GA):
1,05-1,14, puan başına] ile hem iskemik hem de hemorajik inmelerde mekanik ventilasyon uygulanmış olmasıdır [iskemik için: exp (β): 6,18, %95 GA: 3,16-
12,09] ve hemorajik inme için: [exp (β): 26,48, 95% GA: 1,36-515,8]. İnme olgularında PEG uygulaması hastane içi mortalite için bağımsız belirleyici değildi
[exp (β): 1,731, 95% GA: 0,785-3,829]. Ancak, PEG uygulanmış olması taburculuk esnasında iyi prognoza (modifiye Rankin skoru 0-2) sahip olabilme için
anlamlı bir negatif etmen olarak bulundu [exp (β): 0,032, %95 GA: 0,004-0,251]. Hastanede yatan nörovasküler hastaların yaklaşık üçte ikisinde malnütrisyon
ve yutma bozukluğu açısından değerlendirme yapılmıştı. Nutrisyonel status değerlendirmesinin %69’u ve disfaji değerlendirmesinin %76’sı ilk 48 saat içinde
gerçekleştirilmişti. Tüple enteral nütrisyon uygulama oranı %39’du. Beslenme tüplerinin %83,5’i ilk 2 gün içinde yerleştirilirken beslenme tüpü olan hastaların
%28’ine daha sonra PEG açılmıştı.
Sonuç: NöroTek çalışması ile Türkiye’de hastanede yatan akut inme hastalarında nutrisyonel uygulamaların temel kalite ölçütlerine ilişkin ilk güvenilir ve büyük
ölçekli veri sağlanmıştır. Ekonomik olması ve doğruluğu açısından nokta yaygınlık yönteminin bu tip verilerin temini için daha fazla kullanılması mantıklıdır