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Clinical Neuroscience

JULY 30, 2019

Relationship between Status Epilepticus Severity Score and etiology in adult NCSE patients

GENC Fatma, ERDAL Abidin, AKCA Gizem, KARACAY Ertan, GÖKSU Özaydın Eylem, KUTLU Gülnihal, GÖMCELI Bicer Yasemin

Purpose - Nonconvulsive status epilepticus (NCSE) is a heterogeneous, severe neurological disorder of different etiologies. In this study, the outcomes of NCSE episodes was assessed in a large series of adult patients. Our objective was to evaluate relationship between Status Epilepticus Severity Score (STESS) and etiology and the role of etiological factors on predicting the outcomes. Method - In this retrospective study, the medical records of 95 patients over 18 years of age who were diagnosed with NCSE between June 2011 and December 2015 were reviewed. Their treatment and follow-up for NCSE was performed at the Epilepsy Unit in Department of Neurology, Antalya Research and Training Hospital. Etiological factors thought to be responsible for NCSE episodes as well as the prognostic data were retrieved. The etiological factors were classified into three groups as those with a known history of epilepsy (Group 1), primary neurological disorder (Group 2), or systemic/unknown etiology (Group 3). STESS was retrospectively applied to patients. Results - There were 95 participants, 59 of whom were female. Group 1, Group 2, and Group 3 consisted of 11 (7 female), 54 (33 female), and 30 (19 female) patients, respectively. Of the 18 total deaths, 12 occurred in Group 2, and 6 in Group 3. The negative predictive value for a STESS score of ≤ 2 was 93.88% (+LR 2.05 95% CI: 1.44-2.9 and -LR 0.3 95% CI 0.10-0.84 ) in the overall study group. While the corresponding values for Group 1 (patients with epilepsy), Group 2 (patients with primary neurological disorder), and group 3 (patients with systemic or unknown etiology) were 100%, 92.59% (+LR 2.06 95%CI: 1.32-3.21 and -LR 0.28 95% CI 0.08-1.02 ) 83.33% (+LR 1.14 95%CI: 0.59-2.9 and -LR 0.80 95% CI 0.23-2.73). Conclusions - This study included the one of the largest patients series ever reported in whom STESS, a clinical scoring system proposed for use in patients with status epilepticus, has been implemented. Although STESS appeared to be quite useful for predicting a favorable outcome in NCSE patients with epilepsy and primary neurological disorders, its predictive value in patients with systemic or unknown etiology was lower. Further prospective studies including larger NCSE samples are warranted.

Clinical Neuroscience

JULY 30, 2019

Attitude of spine surgeons towards the application of 3D technologies - a survey of AOSpine members

ÉLTES Endre Péter, KISS László, BARTOS Márton, EÖSZE Zsolt, SZÖVÉRFI Zsolt, VARGA Pál Péter, LAZÁRI Áron

Background - 3D technologies (3D virtual and physical model, 3D printing, computer aided engineering, finite element analysis based simulations) play an important role in personalized spine surgery. Objective - In collaboration with AOSpine a global, online survey-based study was performed in order to determine the acceptance rate and the factors which stand against the wider spread of 3D technologies. Methods - A survey containing 21 questions was developed and divided into five pages, every page corresponding to one chapter. Our analysis is based on the responses of 282 spine surgeons from 57 countries. To interpret our results in a global context, we used the Human Development Index of the respondent's countries in comparisons. Results - Significant difference between the AOSpine regions (p ≤ 0.05) was found, with the highest acceptance in Asia-Pacific region. There was no significant difference in acceptance score according to the field of spine surgery, or the surgical experience in years (p=0.77, and p=0.19). In the case of public practice, we found significantly higher acceptance compared to private and mixed (public and private) surgical practice (p ≤ 0.05). The acceptance of the technology varied based on the respondent’s resident country’s Human Development Index and was significantly different between „Medium” vs “Very high” (p = 0.0005) and „High” vs „Very high” (p=0.019) category. Significant positive correlation was found between the acceptance score and the HDI score (Spearman test, ρ = 0.37, p = 0.007). The main limitation factor was identified as the lack of information. Conclusion - There is high interest among spine surgeons towards the incorporation of 3D technologies into the clinical practice. Education, the healthcare system, and the economic environment plays a major role in acceptance. Our results provide the basis of a strategy to promote the application of 3D technologies.

Lege Artis Medicinae

MAY 20, 2019

[Physical inactivity and activity. Damage and benefit]

KÉKES Ede, APOR Péter

[Authors address the issue of inadequate physical activity worldwide and analyze their relationship with cardiovascular diseases and total mortality. In the inactivity "world map" it can be seen that in economically developed countries it is very common but other ethnic and regional factors also play a role and it is significantly more frequent at women. In our country this phenomenon due to combination of advanced civilization and computerization is also frequent. From 2000 to 2015, the trend of the presence of physical inactivity (FI) in the high income populations is steadily rising. Convincing evidence suggests that FI increases the risk of many common, serious diseases, including ischaemic heart disease, type 2 diabetes, breast cancer and colon carcinoma, and reduces the life expectancy. For these four diaseses, the incidence of FI occurs in about 1/3 of cases and 35% of total mortality. Its health value (PAF) ranges from 10 to 18%. Low (non-regular) exercise increases the risk of hypertension with or without family history. In subjects with moderate and intensive levels of physical activity (FA), there is a significantly lower mortality rate and the rate of occurrence of major cardiovasculars (CV) diseases compared to those with lower grade FA. Behind the positive effect of physical activity there is a multiple and complicated mechanism that manifests itself in the vascular system, in the physiological adaptation of the heart and in other metabolic and cellular effects. ]

Clinical Neuroscience

MAY 30, 2019

The prevalence of sarcopenia and dynapenia according to stage among Alzheimer-type dementia patients

YAZAR Tamer, YAZAR Olgun Hülya

Aim - In this study, the aim was to identify the prevalence of sarcopenia and dynapenia according to disease stage among Alzheimer-type dementia (AD) patients and collect data to suggest precautions related to reducing the disease load. Method - The study was completed with 127 patients separated into stages according to Clinical Dementia Rating Scale (CDR) criteria and 279 healthy volunteers aged 18-39 years and 70-80 years abiding by the exclusion criteria who agreed to participate in the research. Our prospective and cross-sectional study applied the CDR and mini mental test (MMSE) to patients with disorder in more than one cognitive area and possible AD diagnosis according to NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer’s Disease and Related Disorders Association) diagnostic criteria. The patient and control groups had skeletal muscle mass index (SMMI), muscle strength and physical performance assessed with sarcopenia diagnosis according to European Working Group on Sarcopenia in Older People (EWGSOP) diagnostic criteria. Results - In our study, in parallel with the increase in disease stage of AD patients, the prevalence of sarcopenia (led by severe sarcopenia) and dynapenia was higher compared to a control group of similar age. Conclusion - In chronic, progressive diseases, like AD, identification of changes in parameters, like muscle mass and strength and reductions in physical performance in the early period, is important for identification and to take precautions in the initial stages considering the limitations of the preventive effects of treatment applied after diagnosis of AD.

Journal of Nursing Theory and Practice

OCTOBER 30, 2018

[Influencing Factors of Parenting Sense of Competence - Focusing on Sense of Coherence]

CSIGÓ Luca, KARÁCSONY Ilona Hajnalka

[The aim of the study: Parenting sense of competence (PSOC) has major impact on children’s development. The aim of this study was to examine the influencing factors of the parenting sense of competence from the aspect of a Health Visitor, especially focusing on sense of coherence (SOC). Material and method: A quantitative, cross-sectional, online study was carried out in 2017. A non-random sampling was applied with 254 mothers, who cared healthy, 0-6-year-old children. A self-edited survey was used and we examined SOC by its standard scale (SOC-13). For the data analysis Chi2 probability was used (p<0,05). Results: The mean age of the mothers was 33 years, 47,8% had 2 children and almost 60%. were higher educated. The mean point of SOC was 58,49. Age and sense of coherence had major impact on PSOC (p<0,05). There was not correlation between the residence, the education level, the marital status and PSOC (p>0,05). However the judgement of the Heath Visitors was excellent, internet was the main source of information about childcare. At the same time, human resources were mostly used in practise. Conclusion: The sociodemographic factors had lower impact on PSOC but it had a strong rela­tion­ship with SOC. In case of a risk groups Health Visitor could be a resource, against physical and psychosocial stressors, and she also could help to develop the parenting sense of competence. The role of the professionals should be enhanced in the parents’ source of knowledge related to their children.]

Journal of Nursing Theory and Practice

DECEMBER 30, 2018

[Pulse Wave Velocity measurement among university students ]

KALMÁR Ágota, PÓSA Gabriella, FINTA Regina, NAGY Edit, SZILÁGYI Levente

[The aim of the study: The purpose of our investigation is to prove the favorable effect of regular physical activity on arteries. Material and method: 42 students (29 women; 13 men; age 24 ±2,71 years) volunteered for our research. Anthropometric data, segmental-, visceral body composition (TanitaSBCA) and arterial stiffness parameters (Arteriograph) were measured. Participants took part in an 8-week training. Interventional-group: started training during our research, control-group: doing sports constantly for years. Results: Compared to the age decadal artertial pulse wave velocity (PWVao) reference value both groups showed significant difference. PWVao significantly improved because of training by the interventional group (6,23±0,79; 5,87±0,59 p<0,01); while in the case of the control group there was no significant change (5,85±0,54; 5,87±0,63 p=0,80). The body composition data showed minimal correlation with PWVao. Conculsion: Regular training has favorable effect on one stiffness parameter of arteries. Already 8 weeks enough to reach significant change to reduce arterial stiffness and this condition can be maintained with long-term regular training.]

Lege Artis Medicinae

MARCH 20, 2019

[The modern therapy of lipid disorders in the daily practice ]

REIBER István

[Elevated LDL-C and/or triglycerides and decreased HDL-C levels contribute to development of vascular lesions. In the absence of detectable vascular disease the lipid values of providing vascular protection preferably with a healthy diet, regular physical activity and by trying to get out of harmful passions. If the healthy lifestyle is not effective enough, lipid-lowering medication may also be necessary in primary prevention. In the cases of inherited lipid disorders and in patients with high or very high cardiovascular risk it is necessary to take lipid lowering medications in effective dose. The Hun­ga­rian and the international guidelines have been formulated the targets of lipid values for vascular protection. The paper is trying to help for everyday medical practice, how to treat the dyslipidemic patients with the application of widely available lipid parameters and lipid lowering medications effectively. ]