FARKLI EPİLEPSİ TÜRLERİNDE VE DİKKAT EKSİKLİĞİ HİPERAKTİVİTE BOZUKLUĞU OLAN ÇOCUKLARDA BİLİSSEL VE DAVRANISSAL BULGULARIN KARSILASTIRILMASI

Bu kesitsel çalısma Gazi Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı, Çocuk Nöroloji ve Çocuk Psikiyatri Bilim Dalları polikliniklerinde takip edilmekte olan 20’si kontrol 120 çocuk üzerinde yapıldı. Arastırma grubuna alınan epilepsili çocuklarda, rolandik ve kompleks parsiyel epilepsi tanısı almıs olmak, son 6 ayda nöbet geçirmemis olmak, tedavi için tek antiepileptik ilaç kullanıyor olmak, sağ elini kullanıyor olmak, değerlendirme döneminde anksiyete ya da depresif bozuklukları olmamak, toplam zeka bölümü 80’in üzerinde olmak kriterleri arandı. DEHB grubuna alınan çocuklarda özgül öğrenme güçlüğü, major depresyon ve kaygı bozuklukları gibi eshastalanım gösteren; ağır ailevi islev bozukluğu ve cinsel/fiziksel kötüye kullanım öyküsü olan hastalar çalısmaya alınmamıstır. Kontrol grubundaki katılımcıların belirlenmesinde öğretmenlerle görüsülmüs ve bir önceki yıl basarı durumu tabloları incelenerek yaklasık ±2 standart sapma arasında kalan denekler örnekleme dahil edilmistir. Çalısmaya alınan çocuklara WISC-R, CADÖ, CÖDÖ, ÇSKÖ, ÇDKÖ, ÇKDE uygulandı. Genel Bilgi ve Sözel Zeka Bölümünde DEHB-DE, DEHB-B, kompleks parsiyel epilepsili hastalar sağlıklı kontrollerden daha düsük puanlar almıslardır. Perfomans Zeka Bölümünde ise DEHB-DE ve kompleks parsiyel epilepsili hastalar kontrollerden düsük puanlar almıslardır. Toplam zeka bölümü açısından gruplar arasında anlamlı fark bulunmamıstır. Rolandik epilepsili hastalar ise sadece Resim tamamlama alttestinden düsük puanlar almıslardır. Ayrıca çalısmamızdaki kompleks parsiyel epilepsili hastalarda toplam zeka bölümü hariç sözel ve performans zeka düsük bulunmustur. Bu çalısma epilepsililerde zeka bölümüyle ve ölçme araçlarının duyarlılığıyla ilgili tartısmaların daha devam edeceğini ve çocukluk epilepsisine komorbid olduğu düsünülen DEHB’ni ve özellikle dikkat eksikliği riskinin arttığı düsüncesini destekler

Usability testing of the New Assessment System for Aged Care

This report provides a stand-alone description of how the national model for assessment in aged care was received when reviewed by the relevant reference groups and when demonstrated to experienced assessors. It covers the preliminary testing of a system that operates across three levels to guide the people requesting assistance to the set of aged care services that they need. The overall aim of the new assessment system has been to simplify and streamline information so it can be used in a practical way in the field to plan how best to meet those needs. The purpose of collecting assessment information is to differentiate between people who: -Have no problems and need no services -Have minor problems (i.e., low need), and need some basic services (e.g., meals, home maintenance), but do not need a comprehensive assessment (Basic Services: Level 1 Assessment) -Have mild to moderate problems and require access to more than a couple of basic services and may require services such as personal care (Basic Plus Services: Level 2 Assessment) -Have a moderate to high problems and/ or complex needs and require a comprehensive assessment (Packaged Care - CACP, EACH, Transition Care /Residential Care Services: Level 3 Assessment). The usability testing and ECRG comments highlighted that assessment information can also be used to produce \u27change scores\u27 at a subsequent point of re-assessment and to allow assessors and service providers to more efficiently \u27inter-operate\u27 across existing aged care programs and with other assessment systems. A wealth of relevant data is already being collected through Medicare-remunerated GPs\u27 assessments, in hospital and community health systems, in rehabilitation units and in palliative care and in outpatient clinics, that are of direct relevance to the new national aged care assessment system. The overall model and the components of a recommended national assessment system have been developed with feedback from the Department of Health and Ageing and its Expert Clinical Reference Group, as well as with feedback from experienced assessors. The initial usability testing of the tool with assessors has resulted in some minor revisions as well as some practical ideas to build into any subsequent stages. The result of this first stage of development is a system that is judged by these initial methods of usability testing to be fit for purpose. The electronic version of the tool that was tested is included in Appendix 1 and the resulting recommended changes are shown in Appendix 2. The next step is expected to be more extensive field testing that should be designed to deal with the wider implementation issues. These are likely to include a proposed data sharing model, a data repository function to enable more extensive empirical testing, examining the linkages to other systems and assessment role delineation (with associated training materials linked to assessor competencies)

Safety and effectiveness of surgical treatment of atrial fibrillation using nitrous oxide-based cryoablation

Purpose: Chronic Atrial Fibrillation (AF) is the most prevalent arrhytmia in patients undergoing cardiac surgery. In this study we aim to share our cryoablation experiences. Material and Methods: We performed 25 cryoablations during cardiac surgery in Adana Numune Education and Research Hospital between September 2013 and July 2014. Patients evaluated retrospectively. The operations were performed with the use of cardiopulmonary bypass (CPB) and cold blood cardioplegia. Results: Fourteen mitral valve replacement, 7 aortic valve replacement and mitral valve replacement, 1 aortic valve replacement and tricuspid repair, 2 coronary artery bypass grafting, 1 coronary artery bypass grafting and aortic valve repair were applied. A -50-(-90) degrees of cryoprobe temperature was applied about 120 seconds. No complications developed in any of the patiens. Postoperative first day, first week, third month and after one year electrocardiography (ECG) of the patiens has evaluated. The corelation between preoperative left atrial diameter (M mode echocardiography) and postoperative first year atrial fibrillation has been investigated with corelation analysis. After one year controlls showed that 17 of 25 patient restored sinus rhytm and 8 of 25 patiens has still atrial fibrillation rhytm. Conclusion: Cryoablation using nitrous oxide based device for the treatment of atrial fibrillation has been applied recently and we consider that it is safe and effective. [Cukurova Med J 2016; 41(1.000): 8-12

Using a high-flow nasal cannula provides superior results to OxyMask delivery in moderate to severe bronchiolitis: a randomized controlled study

The effectiveness of using a face mask with a small diffuser for oxygen delivery (OxyMask) was compared to use of a high-flow nasal cannula (HFNC) in patients with moderate or severe bronchiolitis

Evaluation of Microorganisms Causing Ventilator-Associated Pneumonia in a Pediatric Intensive Care Unit

Objective: The aim of this study was to identify microorganisms causing ventilator-associated pneumonia (VAP) and also study the antibiotic resistance/susceptibility