Electrocardiographic Evaluation in Patients Receiving Lamotrigine Monotherapy/Duotherapy

Objective:Despite its widespread use and safety data, the cardiac safety of lamotrigine was brought into question in October 2020 when the U.S. Food and Drug Administration issued a safety warning about its cardiac side effects. Here, we investigated whether there are differences in electrocardiogram (ECG) findings between epilepsy cases receiving lamotrigine monotherapy and those receiving duotherapy.Methods:Patients older than 16 years who were followed up with a diagnosis of epilepsy and receiving lamotrigine were retrospectively identified. Those receiving only lamotrigine and any second anti-seizure medication (ASM) in addition to lamotrigine were included in the study, and those receiving more than two ASMs were excluded. Eligible patients were asked to apply to any health institution and have an ECG performed. Heart rate, PR distance, QRS duration, QT duration, corrected QT value, and Tp-Tend value were calculated manually, and ST-T changes were evaluated. Comparisons were made between patients receiving monotherapy and dootherapy and those receiving low-dose and high-dose lamotrigine.Results:There were 19 patients receiving monotherapy and 11 receiving duotherapy. The ECG parameters of all other patients were within normal values. When ECG parameters were compared between patients receiving monotherapy and those receiving duotherapy, no significant differences were found in heart rate, PR distance, QRS duration, QT duration, QTc duration, Tp-Tend duration, and presence of ST-T changes. When the patients were divided into low-dose and high-dose lamotrigine groups, there were no significant differences in the ECG parameters between these two groups.Conclusion:The relationship between the use of lamotrigine and cardiac conduction problems in patients with epilepsy has attracted the attention of physicians since its introduction into clinical practice. Although our results did not indicate a significant relationship, there is still a need to determine the risk groups and clarify the pathophysiology of lamotrigine-related arrhythmia through genotype- and phenotype-related studies

Diagnosis of comorbid migraine without aura in patients with idiopathic/genetic epilepsy based on the gray zone approach to the International Classification of Headache Disorders 3 criteria

BackgroundMigraine without aura (MwoA) is a very frequent and remarkable comorbidity in patients with idiopathic/genetic epilepsy (I/GE). Frequently in clinical practice, diagnosis of MwoA may be challenging despite the guidance of current diagnostic criteria of the International Classification of Headache Disorders 3 (ICHD-3). In this study, we aimed to disclose the diagnostic gaps in the diagnosis of comorbid MwoA, using a zone concept, in patients with I/GEs with headaches who were diagnosed by an experienced headache expert.MethodsIn this multicenter study including 809 consecutive patients with a diagnosis of I/GE with or without headache, 163 patients who were diagnosed by an experienced headache expert as having a comorbid MwoA were reevaluated. Eligible patients were divided into three subgroups, namely, full diagnosis, zone I, and zone II according to their status of fulfilling the ICHD-3 criteria. A Classification and Regression Tree (CART) analysis was performed to bring out the meaningful predictors when evaluating patients with I/GEs for MwoA comorbidity, using the variables that were significant in the univariate analysis.ResultsLonger headache duration (<4 h) followed by throbbing pain, higher visual analog scale (VAS) scores, increase of pain by physical activity, nausea/vomiting, and photophobia and/or phonophobia are the main distinguishing clinical characteristics of comorbid MwoA in patients with I/GE, for being classified in the full diagnosis group. Despite being not a part of the main ICHD-3 criteria, the presence of associated symptoms mainly osmophobia and also vertigo/dizziness had the distinguishing capability of being classified into zone subgroups. The most common epilepsy syndromes fulfilling full diagnosis criteria (n = 62) in the CART analysis were 48.39% Juvenile myoclonic epilepsy followed by 25.81% epilepsy with generalized tonic-clonic seizures alone.ConclusionLonger headache duration, throbbing pain, increase of pain by physical activity, photophobia and/or phonophobia, presence of vertigo/dizziness, osmophobia, and higher VAS scores are the main supportive associated factors when applying the ICHD-3 criteria for the comorbid MwoA diagnosis in patients with I/GEs. Evaluating these characteristics could be helpful to close the diagnostic gaps in everyday clinical practice and fasten the diagnostic process of comorbid MwoA in patients with I/GEs

Innovation management in healthcare: Evaluation of mobile healthcare applications by users

Yaşamın her alanında karşımıza çıkan inovasyon, yeni fikirlerin uygulanmasında ve geliştirilmesinde sağlık alanında da başarılı katkılar sağlamaktadır. Özellikle son zamanlarda, hayatımızın önemli bir parçası haline gelen mobil cihazlarda yer alan sağlık uygulamaları, sağlık hizmetlerine ulaşma olanaklarının arttırılmasında çok önemli bir yenilik olarak hayatımıza girmiştir. Çalışmanın temel amacı; sağlık hizmetlerinde bir inovasyon olan mobil sağlık uygulamalarını kullananların kişisel sağlık kayıtlarına dair görüşlerini araştırmaktır. Bu amaçlar doğrultusunda; iki kısımdan oluşan ve ilk kısımda 8 soruluk kişisel bilgiler içeren, ikinci kısımda ise 31 ifadeden oluşan bir ölçüm aracı geliştirilmiştir. Araştırma verilerinin elde edilmesi aşamasında, anket yöntemi tercih edilmiş, 397 mobil sağlık uygulaması kullanıcısından oluşan anket verisi ile analizler yapılmıştır. Analizler yapılırken, SPSS paket programı kullanılmıştır. Araştırma bulgularına göre; çalışmaya katılanların %56,2 si kadın, %43,8i erkektir. Katılımcıların çoğunluğu yani %42,6’sı 31-40 yaş aralığındadır. 51 yaş ve üstü katılımcı oranı %27,2 41-50 yaş aralığındaki katılımcı oranı %15,4 ve 20-30 yaş gurubundaki katılımcı oranı ise %14,9’dur. Yapılan araştırmalarda; ankete katılan bireylerin mobil teknolojileri kullanım sıklığı, uygulamalara güvenleri ve teknolojiyi daha ileri seviyelere taşımak adına gerekli taleplerini içeren verilere başvurulmuştur. Tüm bunların ışığında; mobil sağlık uygulamalarının, mobil teknolojileri daha yaygın kullanan genç yaştaki bireyler gibi, daha ileri yaştaki bireyler için de hayatı daha konforlu yaşamak adına önemli bir yere sahip olduğu değerlendirmesi yapılmıştır. Bugünün gençlerinin, yarının yetişkinleri olacağı düşünüldüğünde, mobil sağlık uygulamalarının, sağlık hizmetlerinin sunulmasında ve pazarlanmasında büyük bir öneme sahip olacağı su götürmez bir gerçektir. Dünya çapında artan nüfus ile birlikte, sağlık sorunları ile başa çıkmada; zamandan ve maliyetten tasarruf sağlayan ve bireylerin sağlıkları ile ilgili bilgi düzeylerinde artış sağlayan mobil teknolojilerin sunduğu faydalardan yararlanılması ve mobil sağlık uygulamalarının geliştirilmesine yönelik daha fazla çalışmanın yapılması gerektiği düşünülmektedir.İnnovation which we encounter in every sphere of life, makes successful contributions to implementation and developments of new ideas in health care service. Health applications in mobile devices which have become an important part of our lives recently, has entered our lives as a very important innovation for increasing the opportunities to reach health care services. The main aim of the study is, exploration the opinions of individuals health care records who use mobile health applications an innovation in health care.İn accordance with this purpose, a measurement tool was developed which consisting of two parts, in the firs part containing 8 personal knowledge and the second part consisting of 31 statements. At the stage of research data acquisition, the survey method was preferred and analyzes were made with the survey data which consisting of 397 mobil health care application users. SPSS packaged software was used for analysis. %56.2 of the participants are female and %43.8 are male. The most of the participants, that is %42.6 are between the ages of 3140. The rate of the participants over the age of 51 is %27.2. The rate of the participants between 41-50 ages is %15.4 and the rate of the participants between 20-30 ages is %14.9. İn the researches, the data including the frequency of use of mobile technology applications, their trust in the applications and necessary demands in order to take the technology to higher level were consulted. İn the light of all this, it has been determined that, mobile health applications make life more comfortable for older persons such as younger persons who use mobile Technologies more widespread. Considering that today’s youth people will be tomorrow’s adults, it is an undeniable fact that mobile health applications will have a great importance in the delivery and marketing of health sevices.With the increasing population around the World, it is thought that more work should be done to benefit from and develop the benefits of mobile Technologies which provide time and cost savings in coping with health problems and increase the level of knowledge about the health of individuals

Fluorescent copper phosphate nanoflowers: A novel toxicity investigation study based on tenebrio molitor linnaeus, 1758 (coleoptera: tenebrionidae) larvae

Organic-inorganic hybrid nanoflowers with commercialization potential are the novel materials and are widely used in many experimental applications, recently. However their potential toxicity values of these nanoflowers are still unknown. In this study, fluorescent copper phosphate nanoflowers (FCPnfs) were first synthesized to constructed via organic-inorganic hybrid nanoflower synthesis method. The morphological features of FCPnfs (acridine orange amount, shape, size) were analyzed. The results showed that different amount of acridine orange caused different morphology and the organic component were homogeneously distributed inside the nanoflowers. These materials were characterized by SEM, EDX, XRD, and FTIR techniques. The toxic effects of the asprepared FCPnfs were investigated in Tenebrio molitor Linnaeus, 1758 (Coleoptera: Tenebrionidae) larvae compared to pure copper phosphate nanoflowers (CPnfs). Nanoflowers were force feed to larvae at the different doses of 0.001, 0.005, 0.010, 0.025, 0.050, 0.100 mg/10 μl. According to probit assay, LC50 and LC99 values of FCPnfs were found 0.490 and 0.145 mg/10 μl, respectively. On the other hand, LC50 and LC99 values of CPnfs were detected 0.066 and 0.172 mg/10 μl, respectively. It was found that the insect exhibited slightly more resistance to CPnfs than FCPnfs when compared to both chemical toxic values. These findings will be offer a new insight into the researchers about knowing the toxic effect of the skeletal structure of new materials to be synthesized using the organic-inorganic hybrid nanoflower method

Performance analysis of two toolkits for interactive projected displays

Mit der Microsoft Kinect wurden Tiefenkameras zu günstigen Preisen für die Allgemeinheit verfügbar. Kombiniert man eine Kinect mit einem Beamer, kann man interaktive projizierte Displays bauen. Das Beste daran ist, dass man dafür keine fest installierten Displays braucht. So können Displays aus jeder beliebigen Oberfläche, egal welcher Form und Struktur, einen Multitouch-Display erzeugen. Zurzeit werden Toolkits entwickelt, die eine bequeme Möglichkeit bieten, interaktive Inhalte für diese Displays bereitzustellen. Aus diesem Grund werden in dieser Fachstudie zwei solche Toolkits untersucht und miteinander verglichen. In einer Nutzerstudie werden mittels eines Fitts' Law Tasks grundlegende Performanz Indikatoren erfasst und ausgewertet. Bei der Auswertung wird nicht nur die Performanz der Toolkits gegenübergestellt, sondern die Ergebnisse werden auch mit der subjektiven Beurteilung der Studienteilnehmer verglichen. Ziel der Fachstudie ist es, jeweils die Vor- und Nachteile beider Toolkits darzustellen.With the release of the Microsoft Kinect, depth cameras became available at reasonable prices to the public. Interactive projected displays can be build by combining a Kinect with a projector and transform any surface no matter what form and structure into a multi touch display. The best thing about it, is the fact that no installed display is needed. Currently, toolkits are developed to provide a convenient way to provide interactive content for these displays. This study paper examines and compares the performance of two such toolkits against each other. Therefore a Fitts' Law task is implemented to help collecting basic performance indicators through a user study. Not only the comparison of the performance of the toolkits is evaluated, but also the subjective participant opinion to each toolkit. The aim of this study paper is to respectively present the advantages and disadvantages of both toolkits