Practices of Patient Relatives Aimed at Preventing Pressure Injuries and Their Experiences of Coping with the Burden of Care: A Qualitative Study.

OBJECTIVE: To determine the practices and coping experiences of the relatives of patients with pressure injuries (PIs). METHODS: The authors used a qualitative, phenomenologic research design. They interviewed 20 relatives of patients with PIs face-to-face using an in-depth semistructured interview form. The data were analyzed using the Colaizzi phenomenologic method. RESULTS: Three categories, 8 main themes, and 22 subthemes emerged from the interviews. The category of "the impact of the need for care on the lives of the patient's relatives" was analyzed according to psychological, social, and physical effects. In the category of "practices to prevent pressure injuries," two themes emerged: practices toward the patient and the environment. Relatives of individuals with PIs have psychological, physical, and social needs. CONCLUSIONS: Providing care to a patient with PIs has psychological, social, and physical effects on the patient's relatives. The care burden mostly affects these caregivers negatively, and they mainly need time for themselves and moral and companion support.

An investigation on the effects of carbamazepine and sodium valproate on neuromuscular transmission.

The aim of this study was to investigate the effects of sodium valproate (SV) and carbamazepine (CBZ) on neuromuscular transmission using single-fibre electromyography (SFEMG) in patients with epilepsy. We performed SFEMG during the voluntary contraction of extensor digitorum communis muscle. 30 epileptic patients taking SV, 25 epileptic patients taking CBZ, and 25 age-matched healthy volunteers were included in the study. Mean jitter values (MCD) of subjects taking SV and CBZ were compared with normal controls. MCD values of subjects taking SV and CBZ were statistically significantly higher than those of control group. Review of the correlation between disease duration and MCD values of patients showed that MCD values were increased with the prolonged use of drugs, and thus, indicated a positive relationship between these two parameters. These results suggest that both SV and CBZ reduce neuromuscular transmission in patients without a neuromuscular junction disease.

Assessment of autonomic nervous system functions and cardiac rhythms in patients using isotretinoin.

AIM: The aim of the study was to analyze the potential effects of isotretinoin, frequently used in the treatment of acne vulgaris these days. MATERIAL AND METHODS: For this purpose, we used the methods of sympathetic skin response (SSR) electrophysiological analysis and electrocardiographic (ECG) analysis in patients using isotretinoin. Thirty patients who were diagnosed with acne vulgaris and treated with oral isotretinoin with a dose of 0.5 mg/kg for at least 1 month were included in the study. In all patients ECG scanning and SSR analysis were performed both before treatment and 1 month after the start of treatment. CONCLUSIONS: This study is very important because SSR results show that increasing the existing sympathetic activity in acne vulgaris after isotretinoin usage could explain the exacerbation in acne lesions for the first month, and according to the ECG results the medication did not cause cardiac side effects.

Evaluation of dapoxetine treatment success in lifelong premature ejaculation patients with penile sympathetic skin response.

Hyperactivity of the sympathetic nervous system may play an important role in primary premature ejaculation (PPE), and dapoxetine, a selective serotonin reuptake inhibitor, plays a role in its treatment. We evaluated the success of dapoxetine treatment in PPE patients with a penile sympathetic skin response (PSSR). Of 63 patients who were admitted to our outpatient clinic between March 2017 and December 2017 with a complaint of premature ejaculation and diagnosed with PPE, 56 completed treatment (minimum 12 tablets) with on-demand use 30 mg of dapoxetine and returned for a follow-up appointment. Before and after treatment, the International Index of Erectile Function (IIEF-5) and Arabic index PE (AIPE) scores, intravaginal ejaculation latency time (IELT), testosterone values and PSSR values were compared. The IELT and AIPE values increased significantly in the 56 patients who were re-evaluated after dapoxetine treatment. No significant changes were observed in testosterone levels and IIEF-5. In the PSSR measurement, while the amplitude decreased, the latency was prolonged significantly. PSSR may be an important determinant in the measurement of dapoxetine treatment success for PPE patients, but additional studies are needed.

Comparison of cytokines and prooxidants/antioxidants markers among adults with refractory versus well-controlled epilepsy: A cross-sectional study.

PURPOSE: This study aims to investigate the serum adiponectin, interleukin (IL)-6 and oxidative stress in epilepsy patients who are refractory or non-refractory to treatments. METHOD: The study comprised 31 refractory epilepsy, 29 well-controlled epilepsy patients and control group including 29 healthy individuals. The serum adiponectin, IL-6, total antioxidant status (TAS), total oxidant status levels (TOS) and oxidative stress index (OSI) were determined. RESULTS: The mean serum adiponectin and TAS levels were significantly lower in the refractory epilepsy patients than in the healty controls, and mean IL-6, TOS and OSI levels were significantly higher. The serum adiponectin, IL-6, TAS, TOS and OSI levels were not significantly different between the well-controlled epilepsy patients and the healthy controls. CONCLUSIONS: The mean serum IL-6 and oxidative stress levels in refractory epilepsy patients were higher and the serum adiponectin level was lower than the healthy control group. These findings may be associated with an increased risk of seizures, atherosclerosis and cardiovascular disease in refractory epilepsy patients.

The association between serum vitamin B12 deficiency and tension-type headache in Turkish children.

This study aimed to determine the relationship between serum vitamin B12 level and tension-type headache. The study groups consisted of 75 patients (40 females, 35 males) with headache and a control group of 49 healthy children (25 females, 24 males). Serum vitamin B12 level < 200 pg/ml was defined as deficient, and < 160 pg/ml as severely deficient. The serum vitamin B12 level was measured by the electrochemiluminescence (ECLIA) method. The serum vitamin B12 levels in the headache and control groups were 273.01 ± 76.77 and 316.22 ± 74.53 pg/ml, with the difference determined as statistically significant (p = 0.003). In the case group, 18/75 patients (24%) had a serum vitamin B12 level below the normal of 200 pg/ml, and in the control group 4/49 (8%) patients were also below the normal range (p = 0.021). The serum vitamin B12 level in the children with tension-type headache was significantly lower than that in the control group. From the results of the study, it was concluded that there may be an association between vitamin B12 level and tension-type headache. However, further clinical studies are needed.

The effect of demographic features on aortic arch anatomy and its role in the etiology of cerebrovascular disease.

PURPOSE: The aim of this study was to retrospectively evaluate the distribution of aortic arches, the relationship with demographic characteristics, and the results of carotid and vertebral artery stenting procedures in patients diagnosed with cerebrovascular disease through the intra-arterial digital subtraction angiography (DSA) technique. METHODS: A retrospective examination was performed on 288 patients diagnosed with cerebrovascular disease, who underwent DSA in the Department of Neurology of Gaziantep University Medical Faculty and Kahramanmaras¸ Sütçü Imam University Medical Faculty. The patients were examined in respect of demographic features and aortic arch anatomic structure characteristics. All demographic characteristics, DSA, carotid, and vertebral artery stent results were recorded. RESULTS: The patients comprised 60.1% males and 39.9% females with a mean age of 58.25 years. Type 2 aortic arch was found in 175 (60.7%) patients, Type 2 aortic arch in 99 (34.3%) patients, and Type 3 aortic arch in 14 (4.8%) patients. The right carotid artery stenosis rate was found to be higher in patients with Type 2 aortic arch (P=0.013). When the patients were evaluated according to the presence of a bovine arch, there was no significant difference in terms of age, carotid, and vertebral artery lesions (P>0.05). CONCLUSION: The aortic arch and its branching properties were not found to have a direct effect on increased risk of cerebrovascular disease or stenting rates. This study can be considered to raise awareness for new studies to demonstrate the effect of aortic arch anatomic differences on cerebrovascular diseases.

Hirayama disease (monomelic amyotrophy) clinically confused for carpal tunnel syndrome.

Hirayama disease (HD) is a rare motor neuron disorder that involves a single upper extremity. It is clinically characterized by weakness and atrophy of the muscles of the hand and forearm. This article presents a 19-year-old woman who visited the orthopedics outpatient clinic with weakness and atrophy in her right hand and was clinically diagnosed with advanced stage carpal tunnel syndrome and scheduled for surgical intervention; she was later diagnosed with HD by an electrophysiological study. As a result, it has been found that a careful electrophysiological study and neurological examination can be used to diagnose HD. In this way, advanced stage carpal tunnel syndrome will be ruled out and patients will be spared from an unnecessary surgical operation.

Oxidative injury associated with stenting of asymptomatic carotid artery stenosis.

BACKGROUND: After carotid artery stenting (CAS), neurological complications that cannot be explained with imaging methods may develop. In our study we aimed to show, using oxidative stress markers, isolated oxidative damage and resulting neurological findings following CAS in patients with asymptomatic carotid artery stenosis. PATIENTS AND METHODS: We included 131 neurologically asymptomatic patients requiring CAS. The neurological findings were evaluated using the modified Rankin Scale (mRS) prior to the procedure, one hour post-procedure, and two days after. Patients with elevated mRS scores but with or without typical hyperintense lesions observed on an MRI and with changes of oxidative stress marker levels at the time (Δtotal-thiol, Δtotal antioxidative status [TAS], and Δtotal oxidant status [TOS]) were evaluated. RESULTS: In the neurological examination carried out one hour prior to the procedure, there were 92 patients with mRS = 0, 20 with mRS = 1, and 12 with mRS = 2. When Δtotal-thiol, ΔTAS, and ΔTOS values and the mRS were compared, it was observed that as the difference in oxidative parameters increased, clinical deterioration also increased proportionally (p = 0.001). CONCLUSIONS: We demonstrate a possible correlation between oxidative damage and neurological findings after CAS which could not be explained by routine imaging methods.

Habituation of sympathetic skin response in migraine and tension type headache.

This study aimed to investigate the changes of habituations in the autonomic function of patients suffering from migraine or tension type headache through sympathetic skin responses. Patients with migraine without aura (n=26), with episodic tension type headache without migraine (n=28) and 30 healthy controls were studied. During continuous stimulation, four blocks of 20 responses were sequentially recorded. Mean amplitude changes in the second, third and fourth blocks are expressed as the percentages of the first block. In both headache groups, there was a lack of habituation compared to the control group.