Evaluation of the origin and educational quality of youtube videos on adrenaline auto-injectors.

Summary: Background. Guidelines highlight the pivotal role of adrenaline auto-injector (AAI) training. However, the standards of visual training platforms has not been determined. Our aim was to evaluate the reliability and quality of the AAI related videos on YouTube. Methods. After a search on YouTube about AAI, all videos were categorized into groups based on their origin and the aim of the content. The quality, reliability, understandibility, and actionability of the videos were evaluated using the Global Quality Scale (GQS), Patient Education Materials Assessment Tool Audovisiual (PEMAT-A/V), Quality Criteria for Consumer Health Information (DISCERN), and a modified DISCERN. In each video, the application steps of AAI were evaluated according to a scale of correct usage. Results. 107 YouTube videos in English were included. No significant difference in terms of views, likes, duration and uploading time was observed between the health and non-health groups whereas the GQS (p=0.001), DISCERN (total: p=0.02, and overall: p=0.094), modified DISCERN (p=0.001) scores were higher in the health group. It was found that scores tended to be higher in educational videos. AAI use was mentioned in 85% videos. The median number of mentioned steps was 6. Conclusions. YouTube is an effective platform for visual learning for the use of AAIs. Although the visibility of the videos is equal independent of the origin, the ones recorded by medical professionals seem to provide the most qualified and reliable information.

Cognition as a parameter in monitoring the effect of multiple sclerosis relapse treatment: A prospective controlled study.

BACKGROUND: Cognitive evaluation was considered to be very important in the relapse period, on the basis of the presence of isolated cognitive attacks and the necessity of monitoring the patient both physically and cognitively. MATERIALS AND METHODS: People with MS (pwMS) who were hospitalized during relapse were included in the study. All MS patients were evaluated by the neurologist with Expanded Disability Status Scale (EDSS), The 9 Hole Peg Test (9HPT) and the Timed 25-Foot Walk Test (T25-FWT). Additionally, all participants were examined cognitively with the Turkish version of the Brief International Cognitive Assessment for MS (BICAMS) battery. Also, schedules were indicated as during relapse before the treatment (pre-treatment) and the first month after relapse (1-month follow-up). RESULTS: A total of 140 MS patients (mean age; 34.98±10.09, mean disease duration; 6.05±5.29 years) and 86 healthy controls (mean age; 36.94±10.83) were included to the present study. The mean EDSS scores in pre-treatment in MS patients was 2.74±1.14 and decreased significantly in the 1-month follow-up (1.74±1.24; p<0.001). The mean SDMT score was lower by 8.76 points in MS patients than in HCs) in pre-treatment and 7.66 points in 1-month follow-up (p<0.001). The mean SDMT scores of all participants increased with measurement time gradually (p<0.001). CONCLUSION: In this study, it was detected which cognitive domains were affected after relapse treatment and cognitive changes in pwMS during relapse and remission periods compared to the healthy controls. All three BICAMS test scores significantly increased in one-month follow-up than the pre-treatment period. The results showed that CVLT-II and BVMT-R scores improved more in pwMS than in HCs, and also SDMT scores of pwMS showed a trend of increase, but was not a significant improvement.

Successful capecitabine desensitization for a delayed-type hypersensitivity reaction

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Bilateral symmetrical adrenal hypermetabolism on FDG PET/CT due to Cushing syndrome in well differentiated neuroendocrine carcinoma / Hipermetabolismo suprarrenal bilateral simétrico en FDG PET/TC por síndrome de Cushing en un carcinoma neuroendocrino bien diferenciado

The 18F-FDG PET/CT scan has been suggested for whole-body imaging to identify ectopic adrenocorticotrophic hormone secreting tumours, but there are some challenges involved. The case of a patient is presented, who was admitted with the pre-diagnosis of ectopic ACTH syndrome. On the CT, a nodular lesion was detected in the medial segment of the right lung. The FDG uptake of the lesion seemed to be increased visually, but was not pathological quantitatively (SUVmax: 1.8) on the PET/CT. There was also diffuse increased uptake (SUVmax: 14.2) in the enlarged adrenal glands. The lesion was reported as a possible malignant lesion with low FDG affinity, such as a low grade neuroendocrine tumour, while the diffuse enlarged adrenal glands with high uptake were interpreted as diffusely hyperplasic, due to Cushing's syndrome. The patient was treated with a surgical wedge resection. The histopathological diagnosis confirmed that the tumour was a grade 1 well-differentiated neuroendocrine carcinoma (AU)

Se ha sugerido el uso de la PET/TC con 18F-FDG para la identificación de tumores que producen secreción ectópica de ACTH, pero ello conlleva algunos retos. Presentamos el caso de un paciente hospitalizado con el diagnóstico de sospecha de síndrome de ACTH ectópica. En la TC se detectó una lesión nodular en el segmento medial del pulmón derecho. La captación de FDG por la lesión parecía aumentada visualmente en la PET/TC, pero no alcanzó rango patológico cuantitativamente (SUV máx: 1,8). Había también una hipercaptación difusa (SUVmáx: 14,2) en las suprarrenales aumentadas de tamaño. La lesión pulmonar fue informada como posible lesión maligna de baja afinidad por la FDG, tal como un tumour neuroendocrino de bajo grado, mientras que las suprarrenales aumentadas y difusamente hipercaptantes fueron interpretadas como hiperplasia difusa por Síndrome de Cushing. El paciente fue tratado quirúrgicamente mediante una resección en cuña: el diagnóstico histopatológico confirmó un carcinoma neuroendocrino grado 1 bien diferenciado (AU)

The view of patients with asthma or chronic obstructive pulmonary disease (COPD) on complementary and alternative medicine

Background: The popularity of complementary and alternative medicine (CAM), particularly for chronic diseases such as asthma, is growing rapidly, but little is known about the characteristics of CAM use by patients with asthma and chronic obstructive pulmonary diseases (COPD). The aim of the present study is to compare the knowledge and preferences of patients with asthma or COPD about CAM, to evaluate the extent, characteristics and possible predictors of CAM use. Methods: A face-to-face interview questionnaire was administered to the patients who attended the Allergic Diseases and Chest Diseases clinics between May 2005-January 2006, and 364 patients answered the questionnaire. Results: 43.1 % (n = 90) of the 209 asthmatic patients, and 43.2 % (n = 67) of the 155 COPD patients had used some type of CAM previously. The asthmatic patients who have been admitted to the Emergency Room(ER) more frequently tend to use CAM methods (p = 0.03), whereas duration of doctor diagnosis, hospitalizations, admissions to ER and to be educated for diseases have a higher impact on CAM use in COPD patients (p = 0.00, p = 0.00, p = 0.00 and p = 0.04, respectively). The most commonly used forms of CAM were herbal medicines (57.8 % vs. 70.1 %) and quail egg (46.7 % vs. 37.3 %) in patients with asthma and COPD, respectively. The reported frequency of the subjective sense of improvement was higher in asthmatic patients than COPD patients but this difference was insignificant (50.0 % vs.39.4 %; p = 0.24). Conclusion: Most of the patients with asthma or COPD prefer alternative medicine. CAM use by patients with COPD should be asked about by their doctors, strongly advised about continuing their medicines and about side effects of CAM

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The effects of calcium channel blocker, flunarizine on spinal reflexes in the cats

Effects of calcium channel blocker flunarizine on spinal monosynaptic reflexes were investigated in spinal cats. Flunarizine was administered locally into the spinal cord (10, 50, 100 microM) and intraperitoneally (5, 10, 20 mg/kg). Adult cats (n = 10), weighing 1.5-3 kg were anesthetized with ketamine (50 mg/kg, i.m.) and artificially ventilated. Animals were spinalized at C1 level. A laminectomy was performed in the lumbosacral region. The ventral and dorsal roots of segment L5 were isolated and a pouch of skin was formed at the site of the dissection to allow the exposed tissues to be covered with liquid paraffin. The temperature was kept at 38.5 degrees C with a heating pad. A polyethylene cannula was introduced into the left carotid artery to monitor blood pressure, which was kept above 100 mmHg. The dorsal root of segment L5 was placed on a silver-silver chloride wire electrode for stimulation through an isolation unit. The reflex potentials were recorded from the ipsilateral L5 ventral root, mounted on a silver-silver chloride wire electrode. The systemic (5, 10, 20 mg/kg) and local (50 and 100 microM) dosages of cinnarizin derivative flunarizine significantly decreased the amplitude of reflex response (p < 0.05). Moreover, the latency of the monosynaptic reflexes was increased after administration of the drug (p < 0.05). Voltage-dependent calcium channels in the spinal cord may play an important role to regulate reflex respond.