The Relationship between Polyneuropathy and Cognitive Functions in Type 2 Diabetes Mellitus Patients

Objectives: Type 2 Diabetes Mellitus (DM) is a risk factor for mild cognitive impairment (MCI), Alzheimer's disease and vascular dementia. However, it is not known which pathophysiological mechanisms lead to impairment in cognitive functions in Type 2 DM. This study aims to compare the cognitive functions of diabetic patients with and without polyneuropathy using standardized MiniMental Test (MMSE) and the Montreal Cognitive Assessment Scale (MoCA) and to assess whether the presence of polyneuropathy is a predictive factor for the development of cognitive impairment

Peripheral component of laryngeal and pharyngeal motor evoked potentials

WOS: 000382713000002PubMed ID: 27318611In this study, the responses of thyroarytenoid (TA) and cricopharyngeus (CP) muscles were simultaneously recorded to peripheral magnetic stimulation of the vagus nerve. Recordings were performed in 13 subjects by means of concentric needle EMG electrodes inserted in the TA and CP. Magnetic shocks were delivered to the vagus nerve with a round coil placed occipitally, while EMG was silent in the TA. In all subjects, clear-cut responses were obtained simultaneously in both muscles. In TA compared to CP, the maximum amplitude of the responses were higher, whereas the onset latency was shorter. Our results revealed that simultaneous recordings of TA and CP motor responses to occipital magnetic stimulation enabled a reliable evaluation of their peripheral innervation by the vagus nerve. (C) 2016 Elsevier Masson SAS. All rights reserved

A Deep Learning Approach to Automatic Tooth Caries Segmentation in Panoramic Radiographs of Children in Primary Dentition, Mixed Dentition, and Permanent Dentition

Objectives: The purpose of this study was to evaluate the effectiveness of dental caries segmentation on the panoramic radiographs taken from children in primary dentition, mixed dentition, and permanent dentition with Artificial Intelligence (AI) models developed using the deep learning method. Methods: This study used 6075 panoramic radiographs taken from children aged between 4 and 14 to develop the AI model. The radiographs included in the study were divided into three groups: primary dentition (n: 1857), mixed dentition (n: 1406), and permanent dentition (n: 2812). The U-Net model implemented with PyTorch library was used for the segmentation of caries lesions. A confusion matrix was used to evaluate model performance. Results: In the primary dentition group, the sensitivity, precision, and F1 scores calculated using the confusion matrix were found to be 0.8525, 0.9128, and 0.8816, respectively. In the mixed dentition group, the sensitivity, precision, and F1 scores calculated using the confusion matrix were found to be 0.7377, 0.9192, and 0.8185, respectively. In the permanent dentition group, the sensitivity, precision, and F1 scores calculated using the confusion matrix were found to be 0.8271, 0.9125, and 0.8677, respectively. In the total group including primary, mixed, and permanent dentition, the sensitivity, precision, and F1 scores calculated using the confusion matrix were 0.8269, 0.9123, and 0.8675, respectively. Conclusions: Deep learning-based AI models are promising tools for the detection and diagnosis of caries in panoramic radiographs taken from children with different dentition

An Observational, Prospective, Multicenter, Registry-Based Cohort Study Comparing Conservative and Medical Management for Patent Ductus Arteriosus

No consensus has been reached on which patent ductus arteriosus (PDAs) in preterm infants require treatment and if so, how, and when they should be treated. A prospective, multicenter, cohort study was conducted to compare the effects of conservative approaches and medical treatment options on ductal closure at discharge, surgical ligation, prematurity-related morbidities, and mortality. Infants between 24(0/7)and 28(6/7)weeks of gestation from 24 neonatal intensive care units were enrolled. Data on PDA management and patients' clinical characteristics were recorded prospectively. Patients with moderate-to-large PDA were compared. Among the 1,193 enrolled infants (26.7 +/- 1.4 weeks and 926 +/- 243 g), 649 (54\%) had no or small PDA, whereas 544 (46\%) had moderate-to-large PDA. One hundred thirty (24\%) infants with moderate-to-large PDA were managed conservatively, in contrast to 414 (76\%) who received medical treatment. Eighty (62\%) of 130 infants who were managed conservatively did not receive any rescue treatment and the PDA closure rate was 53\% at discharge. There were no differences in the rates of late-onset sepsis, necrotizing enterocolitis (NEC), retinopathy of prematurity, intraventricular hemorrhage (>= Grade 3), surgical ligation, and presence of PDA at discharge between conservatively-managed and medically-treated infants (p> 0.05). Multivariate analysis including perinatal factors showed that medical treatment was associated with increased risk for mortality (OR 1.68, 95\% Cl 1.01-2.80,p= 0.046), but decreased risk for BPD or death (BPD/death) (OR 0.59, 95\%Cl 0.37-0.92,p= 0.022). The preferred treatment options were ibuprofen (intravenous 36\%, oral 31\%), and paracetamol (intravenous 26\%, oral 7\%). Infants who were treated with oral paracetamol had higher rates of NEC and mortality in comparison to other treatment options. Infants treated before postnatal day 7 had higher rates of mortality and BPD/death than infants who were conservatively managed or treated beyond day 7 (p= 0.009 and 0.007, respectively). In preterm infants born at <29 weeks of gestation with moderate-to-large PDA, medical treatment did not show any reduction in the rates of open PDA at discharge, surgical or prematurity-related secondary outcomes. In addition to the high incidence of spontaneous closure of PDA in the first week of life, early treatment (<7 days) was associated with higher rates of mortality and BPD/death

A database for screening and registering late onset Pompe disease in Turkey

Included in the study were 350 patients older than 18 years who have a myopathic syndrome without a proven diagnosis by serum creatine kinase (CK) levels, electrodiagnostic studies, and/or muscle pathology, and/or genetic tests for myopathies other than LOPD. Acid alpha glucosidase (GAA) in dried blood spot was measured in each patient at two different university laboratories. LOPD was confirmed by mutation analysis in patients with decreased GAA levels from either both or one of the laboratories. Pre-diagnostic data, recorded by 45 investigators from 32 centers on 350 patients revealed low GAA levels in a total of 21 patients; from both laboratories in 6 and from either one of the laboratories in 15. Among them, genetic testing proved LOPD in 3 of 6 patients and 1 of 15 patients with decreased GAA levels from both or one of the laboratories respectively. Registry was transferred to Turkish Neurological Association after completion of the study for possible future use and development. Our collaborative study enabled collection of a considerable amount of data on the registry in a short time. GAA levels by dried blood spot even from two different laboratories in the same patient may not prove LOPD. LOPD seemed to be rarer in Turkey than in Europe. (C) 2017 Elsevier B.V. All rights reserved

An observational, prospective, multicenter study on rescue high-frequency oscillatory ventilation in neonates failing with conventional ventilation

Backgroun

Incidence and severity of retinopathy of prematurity in Turkey

Background: The purpose of this study was to estimate the current incidence of retinopathy of prematurity (ROP) and the need for treatment in preterm infants in Turkey. Methods: The study included preterm infants who had been screened for ROP between 2011 and 2013 in 49 neonatal intensive care units. Infants with birth weight (BW) ≤1500 g or ≤32 weeks' gestational age and those with BW >1500 g or >32 weeks' GA with an unstable clinical course were included. The incidence of any ROP or severe ROP and treatment modalities were determined. Results: The study population included 15 745 preterm infants: 11 803 (75%) with GA ≤32 weeks, and 3942 (25%) with GA >32 weeks. Overall, 30% were found to have any stage of ROP, and 5% had severe ROP. Severe ROP was diagnosed in 8.2% of infants with BW ≤1500 g and 0.6% of infants with BW >1500 g. Of all infants diagnosed with ROP, 16.5% needed laser photocoagulation, and 20 patients born at >32 weeks' GA required this treatment modality. Vitroretinal surgery was performed in 28 infants with severe ROP: 23 with GA ≤28 weeks and 5 with GA 29-32 weeks. Conclusions: The findings of our study have the important implication that more mature babies are at risk of severe ROP requiring treatment. An effective programme for detecting and treating ROP should be established in Turkey