Measurement of cognitive dynamics during video watching through event-related potentials (ERPs) and oscillations (EROs)

Event-related potentials (ERPs) and oscillations (EROs) are reliable measures of cognition, but they require time-locked electroencephalographic (EEG) data to repetitive triggers that are not available in continuous sensory input streams. However, such real-life-like stimulation by videos or virtual-reality environments may serve as powerful means of creating specific cognitive or affective states and help to investigate dysfunctions in psychiatric and neurological disorders more efficiently. This study aims to develop a method to generate ERPs and EROs during watching videos. Repeated luminance changes were introduced on short video segments, while EEGs of 10 subjects were recorded. The ERP/EROs time-locked to these distortions were analyzed in time and time-frequency domains and tested for their cognitive significance through a long term memory test that included frames from the watched videos. For each subject, ERPs and EROs corresponding to video segments of recalled images with 25% shortest and 25% longest reaction times were compared. ERPs produced by transient luminance changes displayed statistically significant fluctuations both in time and time-frequency domains. Statistical analyses showed that a positivity around 450 ms, a negativity around 500 ms and delta and theta EROs correlated with memory performance. Few studies mixed video streams with simultaneous ERP/ERO experiments with discrete task-relevant or passively presented auditory or somatosensory stimuli, while the present study, by obtaining ERPs and EROs to task-irrelevant events in the same sensory modality as that of the continuous sensory input, produces minimal interference with the main focus of attention on the video stream

The ıncidence of residual neuromuscular blockade associated with single dose of ıntermediate-acting non-depolarizing neuromuscular blocking

Bu çalısmanın amacı saglıklı, eriskin hastalarda endotrakeal entübasyon için uygulanan tek doz orta etki süreli kas gevseticilerine (atrakuryum, vekuronyum ve rokuronyum) baglı erken postoperatif rezidüel nöromusküler blok (PRNB) insidansını ve buna etki eden sonra faktörleri arastırmaktır. Çalısma prospektif, gözlemsel olarak, anestezi sırasında sadece endotrakeal entübasyonu kolaylastırmak için tek doz vekuronyum, atrakuryum veya rokuronyum kullanılan ve ameliyat bittikten sonra derlenme odasına alınan hastalarda yapıldı. Derlenme odasında akselomiyograf ile nöromusküler ileti monitorize edildi ve dörtlü uyarıya yanıt (TOF) oranı ölçüldü; 0,9'un altındaki degerler “PRNB var” olarak kaydedildi. Hastalara kullanılan anestezikler ve kas gevseticisinin seçimi, antidot (neostigmin) kullanımı, ekstübasyon ve derlenme odasına alınma kararları hastayı takip eden anestezi doktoruna bırakıldı. Yas, kilo, cinsiyet, antidot kullanımı, anestezi süresi, ekstübasyondan sonra derlenme odasına alınma süreleri PRNB için risk faktörü olarak alındı, stepwise lojistik regresyon analizi yapıldı. Çalısmaya 84 hasta alındı, vekuronyum, atrakuryum, rokuronyum kullanılan hasta sayısı sırasıyla 29, 28, 27 oldu. Hastaların % 58,3'ne neostigmin yapıldı. Medyan anestezi süresi 80 dakikaydı. Derlenme odasında PRNB insidansı (TOF<0,90) % 13,1 bulundu. Regresyon analizinde cinsiyetin PRNB'u etkiledigi; kadın cinsiyetin, PRNB riskini artırdıgı bulundu (OR: 7,250, %95 CI:1,019-51,593). Diger risk faktörlerinin PRNB'a anlamlı etkisi saptanmadı. Klinik olarak ameliyat nedeni dısında ek risk faktörü tasımayan ve anestezi süresi bir saatten uzun olan hastalarda, “cinsiyet” tek doz orta etkili kas gevseticilerine baglıPRNBinsidansını etkileyebilirThe aim of this study is to investigate the incidence of postoperative residual neuromuscular blockade (PRNB) associated with single-dose intermediate-acting muscle relaxants (atracurium, vecuronium, rocuronium) administered to adult patients for endotracheal intubation during early postoperative period and subsequent factors affecting. This prospective and observational study was conducted after obtaining the permission of the local ethics committee. Adult patients who received a single dose of vecuronium, atracurium or rocuronium during general anesthesia for elective surgical procedure were included in the study. The decisions about the anesthetics and muscle relaxants used on the patients, reversal with neostigmine, extubation and transfer to the recovery room were left to be made by the anesthesiologist following the patient. The patient who was taken into the recovery room had neuromuscular monitoring using accelomyography. Train-of-four (TOF) ratios under 0.9 were recorded as “PRNB present”. Age, weight, gender, reversal, anesthesia duration, time for transfer to the recovery room after extubation were considered risk factors for PRNB, stepwise logistic regression analysis was conducted. This study included 84 patients were given vecuronium (n=29), atracurium (n=28) and rocuronium (27). Reversal was performed with neostigmine in 58.3% of the patients at the end of the operation. The median length of anesthesia was 80 minutes. PRNB incidence (TOF<0.90) in the recovery room was determined to be 13.1%. Based on the regression analysis, PRNB risk was determined to increase in a gender dependent manner in female gender (OR: 7.250, 95%, CI:1.019-51.593). The remaining factors did not have any significant effect on PRNB. In patients who do not have other risk factors in addition to the operation reason and whose anesthesia duration is longer than one hour, “gender” may affect PRNB incidence associated with single-dose intermediate-acting muscle relaxants

Assessment of the requisites of microbiology based infectious disease training under the pressure of consultation needs

<p>Abstract</p> <p>Background</p> <p>Training of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists.</p> <p>Methods</p> <p>A cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included.</p> <p>Results</p> <p>A total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients.</p> <p>Conclusions</p> <p>The results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole.</p

Erişkin Still Hastalığında Belirgin Reaktif Trombositozis

Erişkin still hastalığı (ESH), bilinmeyen nedenlere bağlı gelişen multisistemik inflamatuvar bir hastalıktır. Ateş, artrit ve gövdede tipik olarak görülen somon renklidöküntülerle karakterizedir. Tanı genellikle benzer bulgularla seyreden hastalıkların dışlanmasına ek olarak klinik ve laboratuvar bulgularının birlikteliği ile konur.Lenfadenopati ve lökositoz gibi nonspesifik hematolojik bulgular ve farenjit mevcut olabilir. Reaktif trombositoz ESH’da beklenen bir durumken 1 milyonu geçentrombosit yüksekliği ise nadir görülen bir laboratuvar bulgusudur. Bu olguda erişkin still hastalığına eşlik eden belirgin reaktif trombositoz ve nötrofili ile takip ettiğimiz33 yaşında bir erkek hasta sunulmaktadır. ( Sakarya Tıp Dergisi 2019, 9(2):342-346)Adult still disease (ASD) is a multi system inflammatory disease of unknown origin. It is an inflammatory disease characterized by fever, arthritis and salmon-colored rash typically seen in the body. The diagnosis is usually made by the association of clinical and laboratory findings in addition to exclusion of diseases with similar findings. Nonspecific hematological findings such as lymphadenopathy and leukocytosis and pharyngitis may be present. Reactive thrombocytosis may be seen but platelet levels exceeding 1 million is a rare laboratory finding. In this case report, we present a 33-year-old male patient who was followed with adult still disease and accompanying reactive thrombocytosis and neutrophilia. ( Sakarya Med J 2019, 9(2):342-346

Approaching the children with feeding problems

Çocukluk döneminde sık görülen yeme problemleri sağlıklı çocuklarda %25- 45 oranında görülürken, gelişim geriliği olan çocuklarda bu oran %80’e kadar çıkmaktadır. Sağlıklı çocuklarda yapılan çalışmalarda ebeveynlerin %20-60’ının çocuklarının yeteri kadar yemediğini düşündükleri belirtilmiştir. Yoğun tıbbi ve davranışçı tedavi gerektiren ciddi yeme bozuklukları çocukların %3-10’unda görülmektedir. Bu gözden geçirme yazısında yeme problemi ile getirilen çocuğun değerlendirilme ve izlenme süreçlerinden bahsedilmiştir.Feeding problems in childhood are common, occurring in 25-45% of healthy children and the ratio can be increased up to 80% in children with growth deficiency. Studies with healthy children reported that 20-60% of parents think that their children don’t eat enough. Serious eating disorders which requires intensive medical and behaviour treatment is seen in 3-10% of children. In this review, approach and follow up of a child who was brought to the hospital with feeding problems was studied