Burnout in Turkish Adult Neurology Specialists

Aim:Burnout in medical doctors may worse affect patient care or physical performance of clinician. We aimed to investigate the burnout ratio and the factors associated with burnout in Turkish neurology specialists.Materials and Methods:The neurology specialists in Turkey were included in the study. The participants were asked to fill a questionnaire comprised of 33 questions regarding various thoughts and experiences. The participants gave a response to the questions as follows: strongly disagree, slightly agree, moderately agree, strongly agree, completely agree. According to the meaning value of the question (negative or positive meaning), the answer was given a point in a range of 1-5. Sum of points divided by the maximum point (165) gave a burnout ratio.Results:The mean age was 38.78 (±8.42) years, and the female/male ratio was 461/255. The mean burnout ratio was found to be 46.73% (±8.95). Male sex, academic membership, higher academic degree, working in medical faculty hospital, lower salary, being single or nonparent, nightshift, absence of on call work, or working in the intensive care unit were detected to be associated with a higher burnout ratio. Burnout ratio was in positive correlation with age, number of patients examined, and duration of working hours, but in negative correlation with number of auxiliary staff or neurologists in hospital.Conclusion:Our study is the first study to demonstrate a high burnout ratio in a large sample of Turkish adult neurology specialists. Being male, older, academician, professor, single or nonparent, working in medical faculty hospital or in intensive care, low salary, nightshift, and high patient number or working hours seem to be associated with burnout

Neurobrucellosis Presenting As Leukoencephalopathy and Deafness

Neurological involvement of the central nervous system in brucellosis is uncommon. Sensorineural hearing loss is a rare complication of neurobrucellosis, which has not attracted enough attention among known manifestations. A 50-year-old man presented with headache, deafness and deteriorated in cognitive functions. The presence of diffuse white matter changes on brain magnetic resonance imaging (MRI) and serum and cerebrospinal fluid findings led to the diagnosis of neurobrucellosis. The differential diagnosis of diffuse white matter diseases is constantly expanding. In the background of fever, deafness, demential symptoms, cognitive impairment and extensive white matter disease, neurobrucelosis should be considered

Neurobrucellosis Presenting As Leukoencephalopathy and Deafness

Neurological involvement of the central nervous system in brucellosis is uncommon. Sensorineural hearing loss is a rare complication of neurobrucellosis, which has not attracted enough attention among known manifestations. A 50-year-old man presented with headache, deafness and deteriorated in cognitive functions. The presence of diffuse white matter changes on brain magnetic resonance imaging (MRI) and serum and cerebrospinal fluid findings led to the diagnosis of neurobrucellosis. The differential diagnosis of diffuse white matter diseases is constantly expanding. In the background of fever, deafness, demential symptoms, cognitive impairment and extensive white matter disease, neurobrucelosis should be considere

Contralateral Facial Innervation in Healthy Subjects and in Patients with Peripheral Facial Palsy

Background: We aimed to investigate the extent of the response of the orbicularis oris muscle to stimulation of the contralateral facial nerve both in patients with peripheral facial palsy (PFP) and in healthy subjects. Methods: EMG was performed at 2–6 weeks after the onset of PFP in the patient group and at any time in the healthy control group. We performed nerve conduction testing, electroneurography, and surface and needle EMG. Results: A total of 276 participants (patients/healthy controls: 218/58) were analyzed. The extent of the response of the contralateral orbicularis oris muscles to facial nerve stimulation was higher in healthy controls compared to that in the affected group. The response of the contralateral orbicularis oris muscles to stimulation of the paralyzed facial nerve was more extensive in those patients to whom glucocorticoid or physical therapy had been given. Cross-facial innervation in the orbicularis oris muscle extended up to 1.5 cm in one-third of healthy controls and was higher than that in those with PFP. Glucocorticoid or physical therapy seemed to improve cross-innervation in facial palsy. Conclusions: Our findings suggest that the stimulus leading to the contralateral muscular response is mediated through crossing axons rather than muscular fibers

Can volumetric magnetic resonance imaging evaluations be helpful in the follow-up of cognitive functions in cognitively normal Parkinson’s disease patients?

Background/aim: In this study, besides the evaluation of gray and white matter changes in cognitively normal Parkinson’s disease (PD-CN) patients with volumetric magnetic resonance imaging (MRI) parameters, it was tried to show that some neuropsychological tests may be impaired in PD-CN patients. Materials and methods: Twenty-six PD-CN patients and 26 healthy elderly (HC) participants were included in the current study. Global cognitive status was assessed using the mini-mental state examination (MMSE), and the Montreal cognitive assessment scale (MoCA). Attention and executive functions were evaluated using the Wechsler memory scale-revised (WMS-R) digit span test and trail making test (TMT) part A and part B, the Stroop test, semantic and phonemic fluency tests, and clock drawing test. Magnetic resonance imaging (MRI) was acquired according to the Alzheimer’s disease neuroimaging initiative (ADNI) protocol. Results: There were no significant differences among groups regarding age, sex, handedness, and years of education. In the comparison of the PD-CN group and the HC group, there was a statistical decrease in the total animal scores, lexical fluency, TMT part A and TMT part B scores in the PD-CN group. Subcortical gray matter volumes (GMV) were significantly lower in PD-CN patients. The PD-CN group had a significantly reduced total volume of right putamen and left angular gyrus compared to that in the HC group. We observed that putamen and angular gyrus volumes were lower in PD-CN patients. On the other hand, TMT part B may be a useful pretest in detecting the conversion of mild cognitive impairment in PD. Conclusion: Significant MRI volumetric measurements and neuropsychological test batteries can be helpful in the clinical follow-up in PD-CN patients

Differences in the Differential Expression of MicroRNAs Between Patients with Familial Multiple Sclerosis and Those with Sporadic Multiple Sclerosis

Objective: Multiple sclerosis (MS) is a heterogeneous disease with clinical and immunological features. Most MS cases occursporadically, but a considerable proportion of patients have a family history of MS. The etiology and pathophysiology of MS remainunclear. Recent epidemiological and gene expression studies have indicated that dysregulation of microRNAs (miRNAs) may play arole in MS pathogenesis. This study aimed to evaluate the differential expression of miRNAs in sporadic MS (sMS) and familial MS(FMS) patients.Materials and Methods: This cross-section, single-center study was conducted in 20 FMS and 10 sMS patients and 8 healthycontrols. The patients were in the remission. In total, 2,549 miRNA genes were screened in the blood mononuclear cells from thewhole blood samples of MS patients depending on miRBase 21. Differential expression of miRNAs in MS patients was identifiedcompared with the control group, and miRNAs with a fold change ≥2 were validated using reverse transcription-polymerase chainreaction. Differentially expressed miRNAs were then compared between FMS and sMS patients.Results: Initial findings showed that miR-5100 and hsa-miR-16-2-3p were increased and miR-432-3p was decreased in FMScompared with sMS, whereas miR-548-aa, hsa-miR-142-3p, and miR-451-b were increased in both sMS and FMS, but miR-548-vwas increased only in sMS. Some miRNAs showed the same expression patterns in both groups.Conclusion: Differential expression of certain miRNAs may be a useful biomarker in the diagnosis of MS. This study showed thatmiRNAs may discriminate between FMS and sMS cases and MS subtypes, as indicated in earlier studies.</p