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Effects of immune modulatory treatment on language and psychiatric profile in patients with electrical status epilepticus in sleep (ESES)
No full textElectrical status epilepticus in sleep (ESES) is an electrographic pattern associated with cognitive impairment. Our study aimed to prospectively evaluate the psychiatric findings and language skills in patients diagnosed with ESES and to determine the immune modulatory treatment-responsive subgroups. We assessed the patients for psychiatric features and language skills at the baseline and 12 months after. Psychiatric disorders were screened according to DSM-V criteria. We implemented standardized tests including Clinical Global Impressions-Severity Scale (CGI-S), Revised-Children Anxiety and Depression Scale, Children's Sleep Habits Questionnaire-Abbreviated, Aberrant Behavior Checklist (ABC), and Childhood Autism Rating Scale. We used tests adapted/developed for Turkish language including Test of Language Development-Primary- Fourth Edition: Turkish (TOLDP-4:T), Turkish Non-word Repetition Test (TNRT), Turkish Multilingual Sentence Repetition Test (MultiSIT-TR) and Turkish Communication Development Inventory (TCDI). Disability was evaluated by Pediatric Evaluation of Disability Inventory (PEDI). Thirty-nine patients were included. Psychiatric evaluation revealed attention deficit hyperactivity disorder- like symptoms in 25 patients, intellectual disability in 12, and specific learning disability in 8. Patients were treated with corticosteroids or IVIg in addition to anti-seizure medication. The spike wave indexes improved significantly at the end of follow-up period (80 % (65-91) vs. 37 % (24-65), p < 0.001). After 12 months, statistically significant improvement was found in ABC, CGI-S, TOLDP-4:T, TNRT, MultiSIT-TR, TCDI, and PEDI scores (p < 0.05). Patients with improvement in psychiatric symptoms had earlier age. Phonologic working memory performance was significantly preserved and improved compared to other language domains. Immune modulatory treatments may contribute to improvement of psychiatric symptoms and language skills. Preservation of phonologic working memory and grammar performance might be a valuable feature to differentiate ESES-related language impairment
Author's Reply to "Digital Devices for Arrhythmia Detection: What Is Still Missing?"
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Response to: The Dark Side of 3D Simulation in Breast Augmentation: How to Use Its Advantages and Avoid Its Drawbacks
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Evaluation of sociodemographic and nutrition-related factors for type 2 diabetes risk: a sample from Turkiye
Full text linkBackground Considering the increasing prevalence of diabetes, we aimed to evaluate the risk of diabetes in our sample and its relationship with sociodemographic and nutrition-related factors. Methods We conducted the study in Afyonkarahisar province of Turkiye with participants aged 18-65 years. In this face-to-face study, we used a questionnaire on sociodemographic information and general dietary habits and the FINDRISC screening tool. We also recorded participants' 24-hour food recall and assessed anthropometric measurements. We analyzed epidemiological data using binary logistic regression models to assess possible risk factors associated with the presence of diabetes risk. Results Overall, this study included 3,990 participants, 50.03% (n = 1996) and 49.97% (n = 1994) of whom were males and females, respectively. The FINDRISC score was higher in females (p = 0.001), married individuals (p 30 kg/m(2 )increased the risk by 7.33 folds compared with having a BMI of < 25 kg/m(2). Significant but very low correlation coefficients were found between main meal consumption, energy, lipid and iron intake and diabetes risk (p < 0.001). Conclusions Our findings suggest that increasing age, increasing BMI, lower education level, and having a disease diagnosis can be significant risk factors for diabetes. However, more studies are needed to clarify risk factors, especially those related to nutrition
Türkiye' de Başarılı Yaşlanma Kapsamında Yaşlı Girişimciler ve Yaşlı Mucitler
No full textGünümüzde özellikle sağlık alanındaki gelişmeler sayesinde doğumda beklenen yaşam süresinde artış görülmektedir. Bu artışa ek olarak dünya genelinde
doğum oranlarının düşmesi sonucu yaşlı nüfus genç nüfusa oranla artış göstermektedir. Bu durum giderek yaşlanan toplumların, yaşlanma ile ortaya çıkan
fiziksel, psikolojik ve sosyal problemler ile daha etkili baş etme yöntemleri geliştirmesi gerektiğini işaret etmektedir. Özellikle yaşlı nüfusun genç nüfusa göre
artış göstermesi, politika üreticiler tarafından üretken ve çalışan nüfusun azalması ile ilişkilendirilmiş ve bu bir tedirginliğe sebep olmuştur. Yeni koşullara
ayak uydurmak için hem ulusal hem uluslararası boyutta birçok değişiklik yapılmıştır. Dünya Sağlık Örgütü’nün kronolojik yaşlanma aralıklarını güncellemesi
veya çoğu ülkede emeklilik yaşının daha ileriye çekilmesi bunlardan birkaçıdır. Ne var ki bu güncellemeler yaşlıların özellikle psikolojik anlamda iyilik halinin
desteklenmesini doğrudan etkilememektedir. Bu bağlamda karşımıza “başarılı yaşlanma” kavramı çıkmaktadır. Başarılı yaşlanma kavramı; yaşlı bireylerin
sosyal ve ekonomik anlamda daha aktif bir yaşlılık geçirerek fiziksel ve psikolojik iyilik halini arttırabilmesini kapsamaktadır. Uluslararası düzeyde özellikle
son yıllarda yaşlı bireylerin farklı alanlarda aktif olarak yaşam kalitelerini arttırdıkları ve toplumda üretken hale geldikleri görülmektedir. Bu alanlar içerisinde
eğitim, hizmet sektörü, tarım, girişimcilik, akademi, icat/buluş geliştirme ve sağlık gibi çeşitli alanlar bulunmaktadır. Bunun sağlanması bu bireylerin toplum
tarafından dışlanmaması ve özellikle yönetimler tarafından desteklenmesi ile mümkün olacaktır. Bu anlamda hem uluslararası hem ulusal düzeyde destek
projeleri planlanmıştır. Türkiye’de ise desteklenerek aktif kalabilen yaşlı bireyler kıyasla daha azdır. Bu çalışmada Türkiye’de başarılı yaşlanma kapsamında
yaşlı girişimcilerden ve yaşlı mucitlerden örneklere yer verilmiştir. Buna ek olarak psikiyatri hemşirelerinin yaşlı bireyleri bu anlamda nasıl destekleyebileceği
açıklanmıştırLife expectancy at birth has risen owing to advancements in health. Global falling birth rates are resulting in a more rapid increase in the elderly population
compared to the youth. This indicates that aging populations necessitate improved methods for addressing physical, psychological, and social challenges.
Policymakers are concerned about the decrease in the productive workforce resulting from an aging population. Numerous national and international adjustments have been instituted to accommodate new circumstances. Examples include the World Health Organization’s report on chronological aging intervals
and the retirement age increases in several countries. These adjustments do not immediately influence psychological assistance for the elderly. This setting
presents “successful aging”. Successful aging refers to the capacity of elderly individuals to engage more actively in social and economic activities while
enhancing their physical and mental well-being. In recent years, elderly individuals have enhanced their quality of life and contributed productively to society
globally. These encompass education, service, agriculture, entrepreneurship, academia, invention/discovery, and health. Failing to exclude these individuals
from society and providing assistance through administrative measures will facilitate this outcome. Consequently, international and national support programs have been devised. Nevertheless, Turkey has a limited number of elderly individuals capable of remaining active with assistance. This article presents
instances of successful aging in Turkey through elderly entrepreneurs and inventors. It also elucidates how mental health nurses might assist the elderl
Unlocking the power of gamification: Video game-based breathing vs. conventional breathing exercises on pulmonary and extrapulmonary features in children with asthma
Full text linkObjectiveThe benefits of incorporating breathing exercises as an adjunct to medical treatment in the management of asthma are well established. Video game-based interventions are notable for the additional advantages they offer to children with chronic respiratory diseases; however, research specifically focusing on children with asthma remains limited. This study aimed to compare the effects of video game-based breathing exercises and conventional breathing exercises on pulmonary and extrapulmonary features in children with asthma.MethodsThirty-four children with asthma aged 8-18 years were randomly divided into gamification group (GG) and control group (CG). The GG performed video game-based breathing exercises and the CG performed conventional breathing exercises 5 days a week for 8 wk. Pulmonary function, respiratory and peripheral muscle strength, functional capacity, dyspnea, fatigue, asthma control, and quality of life were assessed at baseline and after 8 wk of training.ResultsPulmonary function, respiratory and peripheral muscle strength, functional capacity, and total and physical dimensions of both fatigue and quality of life improved in both GG and CG; however, the improvement in the GG was greater. Significant changes in inspiratory capacity and improvement in dynamic hyperinflation were found only in the GG. Both methods were insufficient in improving dyspnea and asthma control.ConclusionWhile breathing exercises are beneficial for children with asthma in improving pulmonary and extrapulmonary features, the video game-based method may provide further improvements. More importantly, the video game-based method is superior to the conventional method as it is also successful in improving dynamic hyperinflation
Development and validation of the self-assessment scale for counselling skills in health services
No full textAim: The aim of this study was to develop the Self-Assessment Scale for Counselling Skills in Health Services and to evaluate its psychometric properties. Background: Effective communication and counselling are core competencies for nurses and midwives, essential for ensuring patient satisfaction, adherence to treatment and quality of care. However, there is a lack of multidimensional, validated tools to assess these skills comprehensively in healthcare education and practice. Design: This was an instrument development study. Method: The study followed a systematic scale development process including item generation based on literature and professional standards, expert review for content validity, pilot testing and psychometric evaluation. Data were collected between February and April 2025 from 286 nursing and midwifery students at a foundation university in T & uuml;rkiye. Analyses included Content Validity Index (CVI), Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA) and internal consistency reliability using Cronbach's alpha. Results: The final version of the scale consisted of 44 items grouped under three factors: Communication Skills, Professionalism and Counselling Practice Skills. These factors explained 69.30 % of the total variance. The CVI score was calculated as 0.98. Cronbach's alpha for the total scale was 0.976, indicating excellent reliability. CFA results confirmed acceptable model fit. Conclusion: The Self-Assessment Scale for Counselling Skills in Health Services is a valid and reliable instrument that can be used to evaluate the counselling skills of healthcare students and professionals. It is suitable for use in educational and clinical settings to support skill development and assess the effectiveness of training interventions
Causes of diagnostic and treatment delays in locally advanced breast cancer: a nationwide multicenter survey and electronic health records analysis in Turkiye
Full text linkDelays in breast cancer (BC) diagnosis and treatment negatively impact survival outcomes. Understanding patient- and provider-related factors behind these delays is crucial. This study aimed to identify nationwide reasons for delayed diagnosis and treatment of locally advanced BC in Turkiye. A prospective, multicenter hospital-based survey was conducted across 35 institutions between 2023 and 2024. Patient- and provider-related delays were assessed via a structured 61-item face-to-face survey, supplemented by clinical data from electronic health records. Delays exceeding 3 months were clinically categorized as significant. A total of 1322 women participated from seven regions across Turkiye. Factors contributing to diagnostic delays on a national level included economic reasons (5.5%), lack of family support (3.3%), lack of knowledge (12.4%), lack of time due to household work (3.8%), difficulty in finding an appointment (6.7%), pregnancy-related reasons (1.1%), fear of losing the breast (8.9%), fear of death (9.8%), and transportation difficulties (5.1%). Provider-related delays were infrequent. About 89.3% of the patients had the initial doctor appointment and 89.6% had the first specialist consultation within one month. Treatment planning was predominantly based on a multidisciplinary team decision in 88.3% of patients. Regarding treatment initiation, 93.2% started required treatment within 1 month of decision. Patient-related factors are the major causes of diagnostic delay in Turkiye. On the other hand, from the provider's perspective, the presence of multidisciplinary teams, including dedicated breast surgeons, represents a key factor in ensuring the timely implementation of diagnostic procedures and treatment strategies
Evaluation of the Systemic Inflammation in Patients with Bell's Palsy: Monocyte-to-High-Density Lipoprotein Cholesterol Ratio and Hematologic Indices of Inflammation
Full text linkBackground: We aimed to investigate the prognostic significance of hematological inflammatory indices and monocyte-to-high-density lipoprotein cholesterol ratio (MHR) in the diagnosis and prognosis of Bell's palsy. Method: The study included 156 cases diagnosed with Bell's palsy in the neurology clinic and 156 healthy controls. The patients diagnosed with Bell's palsy were staged according to the House-Brackmann Scoring system. Hematological inflammatory parameters such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) levels, and MHR were calculated from the parameters in the patient files. Result: Hematological inflammatory parameters such as NLR, PLR, SII, SIRI, and MHR were found to be higher in Bell's palsy patients. In addition, these parameters were found to be higher in patients with grade V and above Bell's palsy and in patients who did not respond to treatment, compared to the grade IV group and patients who responded to treatment, respectively. SIRI was an independent predictor of both the diagnosis of the disease and the lack of response to treatment, and this was confirmed by LASSO analysis. Conclusions: This study is among the few that demonstrated predictive models based on hematological inflammatory indices that can aid in both the diagnosis and treatment response assessment of newly diagnosed Bell's palsy patients, validated using the LOOCV method. The findings highlight the potential clinical utility of simple, inexpensive, and practical biomarkers such as NLR, PLR, SII, SIRI, and MHR. These easily accessible parameters may support early diagnosis and prognostic evaluation in routine clinical settings
Posterior Fossa Decompression Followed by Duraplasty with Arachnoid-Preserving Technique for Primary and Recurrent Adult Chiari Malformation Type-1.5: A Comparative Retrospective Study
No full textObjective Most studies on Chiari malformation (CM) are focused on CM Type-1. A new subtype, CM Type-1.5, lacks sufficient research. This study aims to evaluate the long-term surgical outcomes of posterior fossa decompression followed by duraplasty with arachnoid-preserving (PFDD-AP) technique for primary and recurrent CM Type-1.5. Methods The medical charts of patients treated surgically for CM at our institute between January 2011 and January 2022 were reviewed retrospectively. Adult patients consecutively treated for CM Type-1.5 were selected as the core sample for the current study. Group A included primary cases (i.e., patients who had not previously been surgically treated), and Group B included recurrent cases. The surgical outcomes were compared by evaluating clinical and radiological findings. Results Thirty-four CM Type-1.5 cases out of 202 CM cases met the study criteria. Twenty-three and 11 cases represented Group A and Group B, respectively. The female-to-male ratio was 2/1. In Group B, the preoperative herniated tonsil extension and the obex position were statistically significantly longer, and retroversion and retroflexion angles were statistically considerably smaller ([ p = 0.024; Z = - 2.26]; [ p = 0.023; Z = - 2.27]; [ p = 0.031; Z = - 2.29]; and [ p = 0.0002; Z = - 3.72], respectively). For the cases presented with syringomyelia (SM) in both groups ( n = 20), total and partial regression were recorded postoperatively in 65% and 15% of cases, respectively. The satisfactory recovery or improvement rate in neurological symptoms was 94.1%. Discussion Total or partial SM regression occurred following PFDD-AP in most adult patients with CM Type-1.5 who presented with SM. The PFDD-AP approach offers better results with fewer complications and recurrence rates