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Electroencephalography and Neuroimaging Markers of Poor Prognosis in Hypoxic-Ischemic Brain Injury
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2022-01-01) Tavşanlı, Mustafa Emir; Seçkin, Mustafa
ABSTRACT Purpose: Hypoxic-ischemic brain injury (HIBI) can cause coma.Several factors may affect the outcome after HIBI and prediction of the prognosis is challenging in clinical practice.Magnetic Resonance Imaging (MRI) and Electroencephalography (EEG) are two reliable tools to predict the possible outcome after brain damage.We aimed to test the utility of MRI and EEG in predicting the outcome by exploring specific lesion and electrophysiological patterns. Method: Patients admitted to the intensive care unit (ICU) due to hypoxic-ischemic brain injury between January 2017 and March 2020 were retrospectively reviewed.Patients over 18 years of age with a history of cardiac arrest or respiratory problems leading to hypoxic-ischemic brain injury were included in the study. Glasgow Coma Score (GCS) was used as a clinical measure for the level of consciousness.All patients had a Glasgow Coma Score (GCS) of <8 and had both MRI and EEG investigations.Patients were classified as having Poor Outcome (PO) and Good Outcome (GO).Poor outcome defines either death or lack of recovery in consciousness (GCS<8).MRI findings that could lead to a coma state were classified as “MRI-positive”, otherwise were classified as “MRI-negative”. Modified Hockaday Scale was used for grading of EEG. Results: Nineteen patients with HIBI were included. In the MRI-positive group, 87.5% of the patients had poor outcome whereas the remaining 12.5% had good outcome. In the MRI-negative group, 45.5% of the patients had poor outcome whereas the remaining 54.5% had good outcome. According to the Modified Hockaday EEG Grading System, 91% of the patients with a score of Grade 4 and above had poor outcome whereas only the remaining 9% had good outcome. Conclusion: Although MRI is a valuable clinical marker, EEG seems to be more reliable for predicting prognosis in HIBI.The modified Hockaday scale can be useful for determining the cut-off points for the prediction of poor prognosis.
Effect of Treatment Modality on Mobility and Quality of Life in Unstable Intertrochanteric Fractures
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2022-01-01) Karademir, Gökhan; Bilgin, Yücel; Demirel, Mehmet; Polat, Gökhan; Erşen, Ali; Kızılkurt, Taha; Büget, Mehmet İlke; Yazıcıoğlu, Önder
ABSTRACT Purpose: The aim of the study was to investigate mobility and quality of life in patients who underwent osteosynthesis with proximal femoral nail (PFN), or arthroplasty for unstable intertrochanteric fractures. Methods: Treatment outcomes of 117 patients (76 Female/41 Male) who were treated with PFN (Group 1, n=66), hemiarthroplasty (Group 2, n=42), or total hip arthroplasty (Group 3, n=9) between 2008 and 2014 were retrospectively evaluated. The mobility of the patients was evaluated with the Palmer and Parker mobility score, and the quality of life was evaluated with the Barthel quality of life index. Results: The mean ages in the groups were 83.51 (range, 75-97) years, 84.72 (range, 75-109) years, and 83.37 (range, 75-94) years; respectively. The mean follow-up periods were 23.26 (range, 3-43.9) months, 19.24 (range, 3-38) months, and 20.1 (range, 3-40) months; respectively. There was no statistically significant difference between the 3 groups in terms of age and follow-up time (p>0.05). Palmer-Parker mobility scores were 6.23 for Group 1, 3.68 for Group 2, and 4.22 for Group 3. Barthel Indexes were 68.73 for Group 1, 37.75 for Group 2, and 52.77 for Group 3. Group 1 had a statistically significantly higher Palmer-Parker mobility and Barthel Index score than Group 2 and Group 3 (p<0.001). Conclusion: We concluded that osteosynthesis with PFN was more advantageous than hemiarthroplasty or total hip arthroplasty in terms of mobilization and quality of life in patients who were operated on for unstable intertrochanteric fracture.
Is it Really Necessary to Perform Colposcopy in Patients with Ascus and HR HPV Positivity?
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2022-01-01) Özaltın, Selin
ABSTRACT Introduction: Papanicolaou (Pap) smear is a very important screening method for detection of cervİcal cancer or cell changes that can lead to it. Atypical squamous cells of undetermined significance (ASCUS) is the most common abnormality seen among all cervical cytologies with the percentage of 4-5% . Human papillomavirus (HPV) infection is regarded as a major cause of cervical intraepithelial neoplasia (CIN) and cervical cancer. Colposcopy is recommended for all women with high-grade squamous intraepithelial lesion (HSIL) and atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H) for cervical cancer screening . It is also recommended for high-risk HPV (HR HPV) positive women with ASCUS. The aim of this study is to evaluate the importance of colposcopy in patients with ASCUS and HR HPV positivity. Materials and Methods: We performed a retrospective study approved by the ethics committee of Acıbadem University. Women with diagnosis of ASCUS and HR HPV positivity who underwent colposcopic evaluation at 2 different gynecologic oncology clinics of our university from January 2011 to January 2019 were included in our study. The age range was from 21 to 48 and the mean age of patients’ was 29. Subjects who were pregnant, hysterectomized or had previous cytological abnormalities were excluded. Conclusion: In this study, we aimed to evaluate the significance of colposcopy in patients with ASCUS and high-risk HPV positivity, especially strains 16 and 18. As mentioned in some other studies, immediate colposcopy is an expensive screening procedure for further evaluation of ASCUS .
The Effect of Personal Face Mask Use on Hearing Sensitivity Awareness
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2022-01-01) Topdağ, Deniz Özlem; Uğur, Emel
ABSTRACT Background and Objectives: The speech information obtained from the acoustic cue alone is not sufficient. The visual component of speech is crucial for speech perception. This study aims to show that individual hearing sensitivity awareness has increased due to the blocking of visual components of speech as a result of the use of personal face masks with the Covid 19 pandemic. Subjects and Methods: A scale was prepared with questions that measured individuals’ ability to use auditory stimuli in various conditions before and after the pandemic. The scale prepared consists of two sections and a total of 15 items. The questions in the first section are about pre-pandemic hearing loss awareness, and the second section is about post pandemic hearing loss awareness. The age average of 1046 people included in the study was 49.47 ± 11.06. Results: Those who do not feel the need to repeat what was spoken in face-to-face meetings before the pandemic need to repeat what was spoken significantly after the pandemic (p<0.001). The findings show the increased need to repeat spoken words in individuals who wear face masks. Also, people have trouble recognizing speech in noisy environments is due to the absence of visual speech cues, compared to the absence of such trouble before the pandemic. Conclusion: The use of personal face masks in the post-pandemic period has changed the awareness of individual hearing sensitivity due to the disappearance of the visual element of speech.
How should Travel-Related Malaria Management in Emergency Departments of Non-endemic Countries? Single-center Study
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2022-01-01) Gün, Cem; Aldinç, Hasan; Çınar, Orhan; Yaylacı, Serpil; Yılmaz, Gürdal; Türkmen, Süha
ABSTRACT Purpose: Advancements in air travel enabled an increase in traveling to malaria-endemic countries such as those in sub Saharan Africa. An increase in the incidence of imported malaria accompanied these advancements. This study aims to summarize how malaria patients who have imported the disease into non-endemic countries present to the emergency departments and to enlighten physicians in emergency departments by providing suggestions for practical approaches to handling such situations. Methods: This study was conducted retrospectively in a university hospital, from January 1, 2014 to March 1, 2022. Eight years of emergency department records of patients who were examined in the emergency department with a suspected, or definitive diagnosis of malaria were included in the study. Epidemiological and clinical characteristics were evaluated. Results: 892 patients were admitted to the emergency department with suspicion of malaria. Thirty of these patients were diagnosed with malaria, and 846 of the 892 patients were members of airline cabin crews. 94.3% (n=798) of the cabin crew did not use prophylactic medication for malaria. The mean age of the patients was 33.2±8.5. Twenty-five patients were diagnosed via peripheral blood smears, and the remaining three patients were diagnosed with polymerase chain reaction (PCR). Rapid diagnostic tests were positive in 26 out of 28 patients. Conclusion: The risk of acquiring malaria is still high despite short-term visits and airport-limited stays. Travel history should be routinely asked of patients with fever by emergency physicians. Education of people traveling to malaria endemic countries, including cabin crew, regarding malaria prophylaxis and protective measures to prevent mosquito bites plays a crucial role in preventing malaria.