Evaluation of Interictal Electroencephalography Findings in Patients with Focal Epilepsy: Does Secondary Bilateral Synchrony Play a Role on Seizure Frequency?

Amaç: İnteriktal elektroensefalografi (EEG) epilepsi hastaları için günlük pratikte sıklıkla kullanılan, tanı ve tedavi sürecinde önemli olan elektrofizyolojik bir testtir. İnteriktal epileptiform deşarjların (İED) doğru değerlendirilmesi ve sekonder bilateral senkroninin (SBS) tanınması uygun tedavi seçeneklerinin değerlendirilmesi için önemlidir. Bu çalışmada, SBS varlığının nöbet sıklığı, lokalizasyon ve tedavi yanıtında rolü olup olmadığının araştırılması amaçlanmıştır. Gereç ve Yöntem: Bu çalışmada, Namık Kemal Üniversitesi Uygulama ve Araştırma Hastanesi Nöroloji Polikliniği’nde epilepsi tanısı ile takip edilmekte olan 126 hastanın verileri geriye dönük olarak incelenmiştir. Hastaların demografik özellikleri, nöbet sıklığı, lokalizasyonu, tedavi yanıtı ve EEG özellikleri incelenmiş ve 122 hastanın sonuçlarına ulaşılmıştır. Bulgular: Olguların 58’i (%46) kadın, 68’i (%54) erkektir. Yaş ortalaması 36.5±16.4 (15–78) olarak saptanmıştır. On beş hastanın (%12.2) EEG’sinin SBS olarak raporlandığı tespit edilmiştir. Elli dört hastada (%44.2) fokal epileptiform anomali, 12 hastada (%9.8) fokal zemin ritmi düzensizliği (non-epileptik bulgular) saptanmıştır. Semiyolojik özellikler ve EEG bulguları ile birlikte değerlendirildiğinde 44 hasta (%34.9) frontal lob nöbet, 66 hasta (%52.4) temporal lob nöbet ve 16 hasta (%12.6) diğerleri olarak sınıflandırılmıştır. Yüz yirmi altı hastanın 46’sı (%36.5) nöbetsiz iken 15 hastada (%11.9) yılda bir nöbet, 46 hastada (%36.5) 1–6 ayda bir nöbet ve 19 hastada (%15.1) günlük ya da haftalık nöbetler olduğu saptanmıştır. Kırkaltı nöbetsiz hastanın 29’unda (%23) erken dönemde, 17’sinde (%13.5) tedavinin başlanmasından altı ay sonra nöbetsizlik elde edilebilmiştir. Sonuç: İnteriktal EEG’de, İED ve SBS varlığı nöbet sıklığı ve tedavi yanıtı açısından risk faktörü olmamakla birlikte frontal lob nöbetlerde SBS oranı daha yüksektir. Tedavi düzenlenmesinde, İED ve SBS varlığının göz önünde bulundurulması yanlış sonuçlara neden olabilirObjectives: Interictal electroencephalography (EEG) is an electrophysiological test used in daily practice and important in the diagnosis and treatment process for epileptic patients. Accurate assessment of the interictal epileptiform discharges (IEDs) and recognition of secondary bilateral synchrony (SBS) are important for the evaluation of appropriate treatment options. In this study, we investigated whether the presence of SBS is a risk factor for seizure frequency, treatment response, and localization. Methods: In this study, the data of 126 patients who were followed up with the diagnosis of epilepsy in the Neurology Outpatient Clinic of Namık Kemal University Education and Research Hospital were analyzed retrospectively. Demographic characteristics, seizure frequency, localization, treatment response and EEG characteristics of the patients were investigated and the results of 122 patients were obtained. Results: Fifty-eight (46%) of the patients were female, and 68 (54%) were male. The mean age was 36.5±16.4 (15–78) years. EEG of 15 patients (12.2%) was reported as SBS. Focal epileptiform abnormality was detected in 54 patients (44.2%) and focal irregular background activity (non-epileptic findings) was found in 12 patients (9.8%). When semiological features and EEG findings were evaluated together, 44 patients (34.9%) were classified as frontal lobe seizures, 66 patients (52.4%) as temporal lobe seizures, 16 patients (12.6%) as the others. Forty-six patients (36.5%) had no seizures, while 15 (11.9%) had one seizure per year, 46 (36.5%) had one seizure in one to six months, and 19 (15.1%) had daily or weekly seizures. Twenty-nine (23%) of the 46 seizure-free patients became seizure-free in an early stage, 17 patients (13.5%) became seizure-free after the sixth month of the treatment. Conclusion: Although the presence of IED and SBS in interictal EEG is not a risk factor for seizure frequency and treatment response, and the rate of SBS is higher in frontal lobe seizures. The presence of IED and SBS in the management of treatment may lead to false results

Evaluation of Interictal Electroencephalography Findings in Patients with Focal Epilepsy: Does Secondary Bilateral Synchrony Play a Role on Seizure Frequency?

Objectives: Interictal electroencephalography (EEG) is an electrophysiological test used in daily practice and important in the diagnosis and treatment process for epileptic patients. Accurate assessment of the interictal epileptiform discharges (IEDs) and recognition of secondary bilateral synchrony (SBS) are important for the evaluation of appropriate treatment options. In this study, we investigated whether the presence of SBS is a risk factor for seizure frequency, treatment response, and localization. Methods: In this study, the data of 126 patients who were followed up with the diagnosis of epilepsy in the Neurology Outpatient Clinic of Namk Kemal University Education and Research Hospital were analyzed retrospectively. Demographic characteristics, seizure frequency, localization, treatment response and EEG characteristics of the patients were investigated and the results of 122 patients were obtained. Results: Fifty-eight (46%) of the patients were female, and 68 (54%) were male. The mean age was 36.5 +/- 16.4 (15-78) years. EEG of 15 patients (12.2%) was reported as SBS. Focal epileptiform abnormality was detected in 54 patients (44.2%) and focal irregular background activity (non-epileptic findings) was found in 12 patients (9.8%). When semiological features and EEG findings were evaluated together, 44 patients (34.9%) were classified as frontal lobe seizures, 66 patients (52.4%) as temporal lobe seizures, 16 patients (12.6%) as the others. Forty-six patients (36.5%) had no seizures, while 15 (11.9%) had one seizure per year, 46 (36.5%) had one seizure in one to six months, and 19 (15.1%) had daily or weekly seizures. Twenty-nine (23%) of the 46 seizure-free patients became seizure-free in an early stage, 17 patients (13.5%) became seizure-free after the sixth month of the treatment. Conclusion: Although the presence of IED and SBS in interictal EEG is not a risk factor for seizure frequency and treatment response, and the rate of SBS is higher in frontal lobe seizures. The presence of IED and SBS in the management of treatment may lead to false results

Predicting mortality and morbidity of geriatric femoral fractures using a modified frailty index and perioperative features: a prospective, multicentre and observational study

Introduction: Femoral fracture is associated with high geriatric mortality. Frailty is the increased vulnerability to stressors resulting from aging-associated decreases in physiological reserve. We aimed to predict 30-365-day postoperative mortality and morbidity rates using modified frailty index and perioperative characteristics in geriatric femoral fractures. Materials and Method: Using a prospective observational design, data were collected from patients >65 years undergoing femoral fracture surgery from 13 different hospitals in 2016 and 2017. Post-discharge follow-up periods were 30, 90, 180, and 365 days. Age, sex, modified frailty index and anaesthesia types used during surgery were recorded. Renal markers, troponin I and haemoglobin levels were examined preoperatively and postoperatively at 24 and 72 hours. Results: We included 392 patients in this study. The age of the patients were between 65 and 101 (mean, 79 +/- 11.9). Median modified frailty index was 5 (interquartile range, 2-7). Increase in modified frailty index increased mortality rate. Mortality rate at postoperative 30 days was 9.8%, while overall study mortality rate was 23%. Spinal anaesthesia was administered in 205 patients (52.3%, most frequent), followed by general in 110 (28.1%), peripheral nerve blocks in 21 (5.4) and spinal-epidural in 43 (11%). Anaesthesia type affected both intensive care unit (p<0.001) and total hospitalization (p<0.012) duration. A logistic regression model revealed that frailty index, preoperative creatinine and centre type were independent mortality predictors. Conclusion: Increased modified frailty index was associated with higher postoperative mortality risk, thus providing an additional way for improving risk stratification. Preoperative creatinine increase and centre types are determining factors in mortality

Zihin Engelliler Öğretmen Adaylarının Öğretmenlik Uygulaması Dersine ve Uygulama Okullarına İlişkin Beklentilerinin Belirlenmesi

Bu çalışmanın amacı, özel eğitim öğretmen adaylarının Öğretmenlik Uygulaması dersine ve dersin yürütüldüğü uygulama okullarına ilişkin beklentilerinin belirlenmesidir. Çalışmada durum çalışması deseni kullanılmıştır. Çalışmaya, zihin engeliler öğretmenliği programına devam eden ve Öğretmenlik Uygulaması I dersini alan 75 özel eğitim öğretmen adayı katılmıştır. Veriler, açık-uçlu sorulardan oluşmuş, yarı-yapılandırılmış bir görüşme formu kullanılarak toplanmıştır. Verilerin analizinde içerik analiz kullanılmıştır. Değerlendiriciler arası güvenirlik ortalama %97 bulunmuştur. Bulgular, öğretmen adaylarının Öğretmenlik Uygulaması dersiyle ilgili beklentilerinin, dersin amacı, içeriği, işlenişi ve değerlendirmesiyle tutarlı olduğunu ortaya koymaktadır. Öğretmen adaylarının dersin öğretim elemanından hem mesleki hem de kişisel beklentileri olduğu görülmektedir. Öğretmen adayları ayrıca, dersin yürütüldüğü uygulama okullarına ilişkin hem fiziksel hem de sosyal beklentilere; uygulama okulundaki personele ilişkin ise hem mesleki hem de kişisel beklentilere sahiptir. Çalışmanın bulguları, uygulamalara ve ileriki araştırmalara ilişkin öneriler açısından tartışılmıştır

Methodology of a new inflammatory arthritis registry: TReasure

Background/aim: The TReasure registry, created in 2017, is an observational multicenter cohort that includes inflammatory arthritis patients. This article reviews the methodology and objectives of the TReasure registry established to collect data from rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients. Methodology: Fifteen rheumatology centers in Turkey will contribute data to the TReasure database. The actual proprietor of the database is the Hacettepe Rheumatology Association (HRD) and Hacettepe Financial Enterprises. Pharmaceutical companies that operate in Turkey (in alphabetical or er), Abbvie, Amgen, BMS, Celltrion Healthcare, Novartis, Pfizer, Roche, and UCB, support the TReasure registry. TReasure is a web-based database to which users connect through a URL (https://www.trials-network.org/treasure) with their unique identifier and passwords provided for data entry and access. TReasure records demographic and clinical features, comorbidities, radiology and laboratory results, measures of disease activity, and treatment data. Discussion: TReasure will provide us with various types of data, such as a cross-sectional view of the current nationwide status of the patients currently receiving these treatments, and retrospective data as much as allowed by the participating centers' records. Finally, a high-quality prospective dataset will be built over the ensuing years from patients with a new diagnosis of RA or SpA

Studying brain activation during skill acquisition via robot-assisted surgery training

Robot-assisted surgery systems are a recent breakthrough in minimally invasive surgeries, offering numerous benefits to both patients and surgeons including, but not limited to, greater visualization of the operation site, greater precision during operation and shorter hospitalization times. Training on robot-assisted surgery (RAS) systems begins with the use of high-fidelity simulators. Hence, the increasing demand of employing RAS systems has led to a rise in using RAS simulators to train medical doctors. The aim of this study was to investigate the brain activity changes elicited during the skill acquisition of resident surgeons by measuring hemodynamic changes from the prefrontal cortex area via a neuroimaging sensor, namely, functional near-infrared spectroscopy (fNIRS). Twenty-four participants, who are resident medical doctors affiliated with different surgery departments, underwent an RAS simulator training during this study and completed the sponge suturing tasks at three different difficulty levels in two consecutive sessions/blocks. The results reveal that cortical oxygenation changes in the prefrontal cortex were significantly lower during the second training session (Block 2) compared to the initial training session (Block 1) (p < 0.05)

Isolation, purification and determination of some biochemical properties of beta-glucosidase from Muscat of Bornova grape

WOS: 000330357700002This research was undertaken to determine biochemical properties of beta-glucosidase (beta-D-glucoside glucohydrolase, EC 3.2.1.21) isolated from Muscat of Bornova grape. The optimum pH for beta-glucosidase activity was found to be 5.0, and the enzyme showed high activity over a broad pH range of 4.5-6.0. However, due to low activity at pH 3.0, the enzyme is expected to exhibit only a fraction of the maximum activity during grape juice fermentation due to low pH of grape juice. As the temperature increased from 30 to 55 degrees C, the activity increased, too, the maximum activity occurring at 55 degrees C which implies that the enzyme is expected to exhibit a low activity at grape juice fermentation. According to thermal inactivation studies, k(D) values increased as the temperature increased, whereas half-life and D values decreased. Energy of activation (E-a) and Z values were found to be 120.99 kj mol(-1) (r(2) = 0.9776) and 18.08 degrees C (r(2) = 0.9750), respectively. d-glucose and ethyl alcohol inhibited the enzyme at varying degrees depending on the concentration.Research Fund of the University of Cukurova, TurkeyCukurova University [ZF2008.YL.36]This study (ZF2008.YL.36) was funded by the Research Fund of the University of Cukurova, Turkey