Knowledge and Attitude of Healthcare Professionals Towards Ozone Therapy.

In medicine, ozone therapy is used in many instances. This study aims to understand the knowledge and attitudes of healthcare professionals towards ozone therapy. We conducted a cross-sectional survey in a comprehensive hospital between November 2020 and January 2021. In addition to evaluating the sociodemographic characteristics of the healthcare professionals, we performed evaluations through a data collection form that we prepared based on the literature. A total of 544 people were included in the study. We found ozone therapy to be the fifth-most frequently heard (72.2%) and experienced (2%) application among traditional and complementary medical applications. Of the participants, 20.8% (n = 113) correctly answered the questions regarding the methods of application of ozone therapy. We found that the most common route of administration was intravenous administration, with a rate of 56.5% (n = 307). The number of correct answers received for the questions regarding ozone therapy was related to professional experience, sex, and occupation (P = .035, P < .001, and P < .001, respectively). We determined that the knowledge and attitudes of healthcare professionals towards ozone therapy are not satisfactory.

Evaluation of organ weights and ventricular thicknesses in electrocution related deaths based on autopsy reports: A biophysical approach.

OBJECTIVE: To evaluate autopsy reports of the deaths due to electrocution in terms of body mass index, body surface area, and organ weights with a biophysical perspective. METHODS: The retrospective study was conducted in Malatya, Turkiye, and comprised autopsy reports of electrocution cases that were obtained from the local branch of the Council of Forensic Medicine related to the period from 2012 to 2019. Organ weights and ventricular thicknesses were compared in terms of body mass index and body surface area. Electrical marks were also evaluated in detail. Data was analysed using SPSS 18. RESULTS: Of the 45 cases, 36(%) were male and 9(%) were female. The overall mean age was 39±13 years (range: 20-71 years). There were no significant differences in organ weights and ventricular thicknesses in different body mass index groups (p>0.05). The weights of head and heart were significantly different in relation to body surface area (p<0.05), but no significant difference were found for other organs and ventricular thickness (p>0.05). CONCLUSIONS: Comparing the organ weights in electrocution autopsies to normal organ weights may help decide the cause of death. During autopsy, electrical marks should be evaluated by considering the characteristics of the electrical current.

Staff scheduling for residential care under pandemic conditions: The case of COVID-19.

The COVID-19 pandemic severely impacted residential care delivery all around the world. This study investigates the current scheduling methods in residential care facilities in order to enhance them for pandemic conditions. We first define the basic problem that addresses decisions associated with the assignment and scheduling of staff members, who perform a set of tasks required by residents during a planning horizon. This problem includes the minimization of costs associated with the salary of part-time staff members, total overtime, and violations of service time windows. Subsequently, we adapt the basic problem to pandemic conditions by considering the impacts of communal spaces (e.g., shared rooms) and a cohorting policy (classification of residents based on their risk of infection) on the spread of infectious diseases. We introduce a new objective function that minimizes the number of distinct staff members serving each room of residents. Likewise, we propose a new objective function for the cohorting policy that aims to minimize the number of distinct cohorts served by each staff member. A new constraint is incorporated that forces staff members to serve only one cohort within a shift. We present a population-based heuristic algorithm to solve this problem. Through a comparison with two benchmark solution approaches (a mathematical programme and a non-dominated archiving ant colony optimization algorithm), the superiority of the heuristic algorithm is shown regarding solution quality and CPU time. Finally, we conduct numerical analyses to present managerial implications.

Could Some Laboratory Parameters Predict Mortality in COVID-19?

BACKGROUND: The number of confirmed cases of COVID-19 continues to increase worldwide and threatens public health. Our aim in this study is to examine the relationship between some laboratory parameters and hematological ratios with the severity of the disease and hospital mortality. METHODS: This study was designed as a retrospective cohort. The clinical data of 743 COVID-19 diagnosed patients who were eligible for hospitalization between March 16, and May 15, 2020 analyzed, retrospectively. The patients were separated into two groups as discharged from hospital (n = 681) and dead in hospital (n = 62). ROC curves and cutoff values of NLR (Neutrophil/Lymphocyte Ratio), PLR (Platelet/Lymphocyte Ratio), MLR (Monocyte/ Lymphocyte Ratio), CRP, and ferritin upon admission to hospital were calculated for the two groups. Binary Logistic Regression used to determine independent risk factors for mortality. RESULTS: The difference between both groups for age, duration in hospital, WBC, neutrophil, lymphocyte, NLR, PLR, MLR, CRP, and ferritin values were statistically significant. NLR had the highest area under the curve with a cutoff of 5.5 in the ROC curve [(AUC: 0.892, 95% CI: 0.844 - 0.939); Sensitivity = 85%, Specificity = 84%]. NLR, MLR, PLR, CRP and Ferritin groups have significant effects on the survival times of the Covid-19 patients. According to logistic regression analysis, increments of NLR (OR = 18.1, 95% CI: 6.4 - 51.4), CRP (OR = 5.5, 95% CI: 2.5 - 12.2), and age (OR = 2.7 95% CI: 1.3 - 5.5) values proportionally increase the death probability. CONCLUSIONS: NLR, CRP, and age are independent risk factors for mortality from COVID-19. We believe that evaluating these parameters together during diagnosis will be important in predicting the prognosis of the disease and in treatment approaches.

Investigation of the disease process and drug combinations in patients with suspected/confirmed COVID-19 using favipiravir.

AIMS: It is aimed to investigate the disease processes and drug combinations in patients who received favipiravir treatment. METHODS: This cross-sectional, analytical and retrospective study included all patients aged ≥18 years (n = 502) who were hospitalised in Samsun, Turkey, for COVID-19 and were given favipiravir from the date between 25 March 2020 and 3 June 2020. RESULTS: In total, 58.6% (n = 294) of the patients were male and 24.5% (n = 123) were between the ages of 71 and 80 years. During the first case process, the mortality rate was 19.9%, whereas the rate of those who were discharged as is/followed up at home for 14 days was 37.3%. During the second case process, the mortality rate was 6.2%, and the rate of those who was discharged as is/followed up at home for 14 days was 65.6%. The mean length of hospital stay was 10.61 ± 8.17 days for the first and 7.97 ± 4.16 days for the second hospitalisation; this difference was significant. Mortality risk of those who used Tocilizumab or vitamin C beside Favipiravir was higher than those who did not. The length of hospital stay was higher in patients using tocilizumab than in those who did not (P < .001). CONCLUSION: Administration of favipiravir later in the course of the disease makes it difficult to achieve the true efficacy expected from the drug and also makes it difficult for other combination drugs to contribute to survival. Favipiravir may also be effective in case of recurrence.

Evaluation of painkillers according to the principles of rational drug use in patients registered to a family medicine unit.

AIMS: We aimed to evaluate knowledge, attitudes and usage of the painkillers within the framework of rational drug use. METHODS: This study was conducted in a family medicine unit with a questionnaire consists of 27 questions. RESULTS: Total of 506 patients participated in the study. The number of people who used pain medication every day was 29 (5.7%) and paracetamol was the most common analgesic (51.1%). The use of painkillers was more common in women and amongst the patients over 65 years of age. The rate of those who preferred painkillers in the form of pills was higher in married patients and the singles preferred injectables (P = .004). Inappropriate use of painkillers was much more prominent in nonsteroidal antiinflammatory drug users (P < .05). CONCLUSION: Demographic features and disease characteristics were the notable factors that affected painkillers selection and the level of knowledge about them.

Palivizumab prophylaxis, respiratory syncytial virus and subsequent development of asthma.

BACKGROUND: Respiratory syncytial virus (RSV) infection is a disease commonly encountered during childhood and it may relapse. An experience in the early childhood would induce asthma development in the future. Palivizumab has a proven efficacy for the RSV prophylaxis so it may prevent asthma. Our aim was to evaluate the possible protective effect of palivizumab on the development of asthma by using the modified Asthma Predictive Index (mAPI). METHODS: This study's data consist of 339 children between 2 to 5 years of age followed up in healthy children unit from 2008 to 2011. Cases were evaluated in terms of wheezing frequency and characteristic features. Evaluations were performed among three groups; palivizumab-treated children born preterm (group 1), palivizumab-untreated children born preterm (group 2) and term newborn children (group 3) with equal number of patients in each group (N.=113). RESULTS: Frequency of the answers about children's experienced wheezing times was significant between groups (P=0.003). A significant difference was found between the groups in terms of the clinician who diagnosed asthma (P=0.045). The groups were compared in terms of the mAPI positivity and a significant difference was found among the groups (P=0.001). Group 1 had lowest and group 3 had highest positivity. Group 1 and group 3 were different (P=0.000), group 2 was found higher than group 1, but was similar to group 3 (P=0.628). CONCLUSIONS: This study supports the benefit of administration of palivizumab to premature children to reduce the risk of asthma development.

Author-based journal selection system that helps authors save time in article submission.

Submission to journals takes a lot of time and format related submission requirements vary greatly from one journal to another. Lack of time and motivation in academia reduces scientific outputs and demotivates researchers. Author-based journal selection system (ABJSS) is a platform for pooling manuscripts conceived to minimize the time spent for manuscript submission and to increase scientific output. The system will provide two types of account: "Author" and "Journal Administrator". Each account type will have its own abilities and permissions. The ABJJS system is an ongoing project that will be designed in cooperation with IT experts and academicians and it will be presented to the scientific world as soon as it secures sufficient support.

The IL-8 Gene Polymorphisms in Behçet's Disease Observed in Denizli Province of Turkey.

Behçet's disease is a multisystemic inflammatory disorder as a triad of symptoms including recurrent oral and genital aphthous ulceration and uveitis with unknown pathogenesis. IL-8, a proinflammatory cytokine, has been found increased in the active stage of BD. DNA samples were obtained from 88 patients with BD and 112 healthy control subjects in Denizli province of Turkey. All genotyping experiments of SNPs in IL-8 gene were performed using polymerase chain reaction-restriction fragment polymorphism. We found that IL-8 -845 T > C and -738 T > A sites are non-polymorphic. There were no differences in the polymorphisms of IL-8 +396 G/T, +781 C/T, and +1633 C/T sites except IL-8 -251 T > A in between patients and healthy controls. Analysis of IL-8 polymorphisms indicates that the distribution of frequencies seems to be associated with -251 T > A and gender, -251 T > A and erythema nodosum, -251 T > A and ocular involvement, +781 C > T and erythema nodosum, +396 G > T and pathergy positivity, and +1633 C > T and papulopustular lesion. We demonstrated that the frequencies of IL-8 haplotypes were significantly different with BD patients than control group. We found that the distribution of IL-8 haplotypes was significantly different with genital ulcers, ocular involvement, positive pathergy test, erythema nodosum, papulopustular lesions, and arthritis with BD patients than healthy control individuals. Our study suggests that IL-8 gene polymorphisms may affect susceptibility to BD and increase the risk of developing disease. In order to confirm and assess the association of IL-8 and other cytokine gene polymorphisms in the pathophysiology of BD, large cohort studies are needed.

Analysis of the population genetic structure of Hb D-Los Angeles [ß121 (GH4) Glu→Gln GAA→CAA] in Denizli, Turkey; genetic diversity, historical demography and estimation of the mutation rates based on haplotype variation.

OBJECTIVE: Understanding the genetic origin of the Hb D-Los Angeles hemoglobin may elucidate population interactions such as movements, migrations, and environmental effects on mutation mechanisms in human biology throughout history. Our study aimed to understand the genetic origin of Hb D-Los Angeles based on haplotype data, observed in the Denizli province of Turkey. METHODS: We studied DNA samples from 40 unrelated patients with abnormal hemoglobin Hb D-Los Angeles and 59 unrelated healthy subjects from our DNA bank. Possible associated haplotypes, HWE, genetic diversity and population differentiation, population genetic structure analysis and historical-demographic analysis for the two populations were determined by Arlequin ver. 3.5. RESULTS: Molecular diversity results from the two populations show that both populations are genetically similar as far as development and expansion during the historical period. Historical gene flow results show high gene flow between the two populations. SSD and rg tests failed to reject the null hypothesis of population expansion which is consistent with unimodal distribution. Our estimated τ values show that the average time since the demographic expansion for normal and Hb D-Los Angeles populations ranged from approximately 42,000-38,000 ybp, respectively. CONCLUSIONS: Our data suggest that the Hb D-Los Angeles population originated within the normal population in Denizli, Turkey. Our results support the hypothesis that the Hb D-Los Angeles mutation may have originated in the Mediterranean area, independent from other populations such as India and China. The evaluation of such data may contribute valuable information to anthropological, paleoclimatic, archaeological, and phylogeographical approaches to human biology throughout the historical period. Am. J. Hum. Biol. 28:476-483, 2016. © 2015 Wiley Periodicals, Inc.

The Relation of Religious Attitudes and Behaviours with Depression in Boarding Quran Course Students.

BACKGROUND: Boarding Quran courses are religious institutions where course attendees spend large part of the year. Depression is an ever-increasing health problem. So, it is worth to study on the effects of religion concept and religious belief and behaviours' that religion concept brings, on depression. The main purpose of this study, is to analyse the effect of religious attitudes and behaviours on depression in Quran course / hafiz students. SUBJECTS AND METHODS: The study is a cross sectional, case-control survey research. Boarding Quran courses and high schools were visited in Samsun city. A total of 956 participants enrolled between June 2015 and December 2015 were included into study from Samsun city of Turkey. Volunteers, 13 years and over ones without any psychiatric disorders were included in the study. Religious attitude-behaviour inventory and Beck's depression inventory were used in the study. RESULTS: Median point of case group attitude scale was 49, control group's was 57 and difference among both has a statistical meaning (p<0.001). Beck's depression score average of case group is 12.93±9.33, its control group's average is 13.74±11.14 and difference between them is not important. Median score of both groups are 11. When scores of attitude and depression scales compared with each other in terms of demographic parameters, there is a difference among group, gender, age and education parameters (p<0.001). CONCLUSIONS: It was seen that religious attitudes and behaviours can be protective for boarding Quran course students but it cannot be enough by itself.

Treatment of migration and extrusion of the gold weight eyelid implant with fascia lata sandwich graft technique.

Gold weight implantation is generally considered a safe procedure for the treatment of paralytic lagophthalmos. The most frequently seen complications are extrusion, malpositioning, and migration of the implant. To decrease the rate of these complications, several modifications were defined in the composition and the shape of the implant as well as the surgical technique itself. Despite these precautions, implant revision rates are still as high as 8% to 14%. Nowadays, implant-covering or implant-wrapping procedures are becoming more popular to avoid implant-related problems. However, there is limited information in the literature regarding the management of these complications. In this study, we aimed to present the treatment of migration and extrusion of the gold weight implant in a patient with Moebius syndrome by wrapping the implant with autogenous fascia lata graft.

Combined thalamic and pallidal deep brain stimulation in diabetic hemiballism/hemichorea.

Hemiballism/hemichorea (HH) is a hyperkinetic movement disorder observed mostly in older adults with cerebrovascular diseases. Although the symptoms improve without any treatment, lesioning or DBS (deep brain stimulation) may be rarely required to provide symptomatic relief for patients with severe involuntary movements. HH is a rare complication of uncontrolled diabetes. There are only a few reported cases of diabetic HH that have been surgically treated. Thus, herein, we have reported the case of a 75-year-old female with type-II diabetes mellitus that presented with disabling involuntary limb movements of the left side, despite being treated conservatively for six months. DBS targeting the globus pallidus internus (GPi) and ventral intermediate (Vim) thalamic nucleus was performed. Complete resolution of symptoms was achieved with a combined stimulation of the thalamic Vim nucleus (at 1.7 mA) and GPi (at 2.4 mA). The combined stimulation of the Vim nucleus and GPi effectively resolved the diabetes-induced HH symptoms in our patient. Thus, although certain conclusions cannot be drawn due to the rarity of the surgically treated patients with HH, the combined stimulation is a novel treatment option for resistant HH.

Evaluation of the reasons for the non­COVID­19 status: A socio­demographic analysis.

The present study aimed to evaluate the reasons behind the fact that some individuals did not contract coronavirus disease 2019 (COVID-19), considering certain socio-demographic data. The present cross-sectional study was conducted at a state hospital between February 1, 2022 and March 1, 2022. The study group consisted of individuals who never had COVID-19, and the control group consisted of individuals who did not know at the time of the study whether they had COVID-19. A data collection form consisting of 29 questions created based on a literature review was used. A total of 2,958 subjects (study group, 669; control group, 2,289) were included; of these, 53.1% were females and 46.9% were males. It was found that housewives (P<0.001), individuals with secondary school and lower education levels (P=0.02), those residing in rural areas (P=0.003), those who received a combination vaccine (P<0.001), those with chronic diseases (P=0.016), those who consumed more fruits (P=0.001), those who used N95 masks (P=0.002), those with pets (P<0.001) and those who did not follow the news regarding COVID-19 (P=0.016) had a higher probability of not contracting COVID-19. On the whole, the present study observed that socio-demographic factors affected the non-COVID-19 status.

A Morphometric Study of Cadavers for the Anterior Approach to the Lower Lumbar Spine.

AIM: To explore the relationship between the retroperitoneal vasculature and anterior surface of the lower spine, and to establish values for aiding in prediction of the pertinence of anterior approach at the L4-L5 and L5-S1 intervertebral discs. MATERIAL AND METHODS: The study included 13 fresh human cadavers. After exploration of the abdominal cavity and removal of the visceral organs, the vasculature, and anterior spinal surface were revealed beneath the lower extension of the perirenal fascia. Morphometric measurements of the great vessels and the intervertebral discs were obtained. All measurements were analyzed and presented as mean and standard deviation. Differences in the values between sexes were assessed. RESULTS: The anterior height of the L4-L5 and L5-S1 intervertebral disc was 6.8 ± 0.81 mm and 6.7 ± 0.99 mm, respectively. The widths of the aorta, inferior vena cava, right and left common iliac arteries, and right, and left common iliac veins were 16.4 ± 3.58, 20.6 ± 3.36, 11.5 ± 2.32, 11.5 ± 2.43, 14.7 ± 3.13, and 15.5 ± 3.27 mm, respectively. The mean aortic bifurcation angle was 45.5°. The aortic bifurcation was located above the lower endplate of the L4 vertebrae in 53.8% of the cadavers. The area of the interarterial and interiliac trigones was 14.6 ± 5.33 cm < sup > 2 < /sup > and 7.1 ± 4.35 cm2, respectively. No statistically significant differences were noted between the sexes. CONCLUSION: An elaborate radiological examination of the vasculature should be performed prior to surgery to avoid unwanted vascular complications during the anterior approach. Knowing the area of the interarterial and interiliac triangles and the aortic bifurcation location could be aid in assessing the safe working zone.

Gamma Knife radiosurgery for the treatment of trigeminal neuralgia: A single center-experience.

INTRODUCTION AND OBJECTIVES: We aimed to assess the outcomes of patients with trigeminal neuralgia (TGN) who underwent Gamma Knife radiosurgery (GKRS). MATERIALS AND METHODS: Fifty-three patients with typical TGN underwent GKRS from May 2012 until December 2022. Among these patients, 45 patients who were follow-up for at least 12 months were included in the study. A mean dose of 87.5 Gy (range, 80-90) was administered to the trigeminal nerve. Postoperatively, outcome was considered excellent if the patient was pain- and medication-free. RESULTS: The mean symtpom duration was 9.53 years, and the mean patient age was 59.8 years (range, 34-85). The mean follow-up period was 46.8 months (range, 12-127 months). 46.7% of patients had a history of previous surgical interventions. A single nerve division was affected in 14 patients (31.1%), and multiple divisions were affected in 31 patients (68.9%). The rate of initial pain relief was 80%. Hypoesthesia in the area of trigeminal nerve developed in 30 (66.7%). Twenty patients (44.4%) exhibited excellent results within 72.4 months. Recurrence occurred in 11 patients (24.4%) with 27.6 months. CONCLUSIONS: Our results suggest that GKRS is a safe and effective procedure. Thus, it is an attractive first- and second-line treatment choice for TGN.

Unusual palliative medicine intervention: smoking cessation.

Intervention for smoking cessation in a palliative care setting is not considered to be a standard practise. However, palliative care should support life and improve its quality and be able to approach the patient from a psychosocial perspective. This article discusses the smoking cessation intervention provided in a palliative care setting for an oncology patient. Making patients quit tobacco products in palliative care can increase the effectiveness of cancer treatment as well as the motivation level of the patient.

Associations of IL-17 and IL-17 receptor polymorphisms with Behçet's disease in Denizli Province of Turkey.

Although the etiopathogenesis of Behçet's disease is not known, studies conducted in different populations show that it is a multifactorial disease that is thought to develop as a result of the interaction of environmental and genetic factors. IL-17 is thought to induce the neutrophilic inflammation and the tissue damage mediated by immune response in patients. Polymorphisms in the gene region encoding IL-17 and IL-17R molecules may play a critical role in the pathogenesis of the disease and contribute to the elucidation of disease mechanism. We aimed to show the association of IL-17A, IL-17F, and IL-17RC polymorphisms and haplotypes in Behçet's disease patients and its clinical features. We genotyped IL-17A (rs4711998 (A/G), rs8193036 (C/T), rs2275913 (A/G), rs3819025 (A/G), rs8193038 (A/G), rs3804513 (A/T), rs1974226 (C/T), rs3748067 (C/T)); IL-17F (rs763780 (T/C), rs2397084 (T/C)); and IL-17R (IL-17RC) (rs708567 (C/T)) polymorphisms in 88 patients with Behçet's disease and 133 healthy controls using PCR-RFLP-based approach. The results of our study showed that polymorphisms of IL-17A, rs8193036 (C/T), rs3819025 (G/A), rs3804513 (A/T), IL-17F rs2397084 (T/C), and IL-17RC rs708567 (C/T) are associated with the susceptibility to the BD. When the haplotype distributions of all loci of IL-17Aand IL-17A/IL-17F together were examined and in contrast to the data obtained from the controls, the GTGGAACC (27.84%) and GTGGAACCTT (25.57%) have the highest frequencies. In conclusion, the allele and genotype frequency differences of the IL-17A, IL-17F, and IL-17R and haplotype frequencies between Behçet's disease and controls indicate that the genetic structure of Behçet's disease may be different.

The Potential Use of Monocyte-to-High-Density Lipoprotein Ratio as a Chronic Inflammatory Marker in Major Depressive Disorder.

Background: Monocytes secrete pro-inflammatory and pro-oxidant cytokines as part of inflammatory reactions. High-density lipoproteins have anti-inflammatory and antioxidant effects. This study investigated the potential use of the monocyte-to-high-density lipoprotein ratio in the follow-up of major depressive disorder. Methods: The study group was composed of patients with newly diagnosed or preexisting major depressive disorder who applied to a psychiatric clinic and did not receive antidepressant treatment in the last 2 weeks. These patients were tested for the monocyte-to-high-density lipoprotein ratio in the psychiatric outpatient clinic both in the first interview and at their follow-up at 2 months. The control group, on the other hand, consisted of subjects who presented to the checkup clinic without any complaints. Results: The study included a total of 98 individuals aged between 18 and 62 years, including 66 women and 32 men. The proportion of women in the study group was higher than that in the control group (P = .002). Patients in the study group had higher first high-density lipoprotein levels than healthy controls (P = .026). Beck's Depression Inventory scores of the study group decreased significantly from the first to the second interview (P < .001). There was no significant correlation between the percentage of change in Beck's Depression Inventory scores and the percentage of change in the monocyte-to-high-density lipoprotein ratio (P = .271). Conclusion: The high-density lipoprotein levels in healthy controls were not higher than those in the group with major depressive disorder; monocyte levels did not differ between the groups and the monocyte-to-high-density lipoprotein ratio was not superior to Beck's Depression Inventory and could not be used in prognosis.

Direct transcatheter aortic valve implantation (TAVI) decreases silent cerebral infarction when compared to routine balloon valvuloplasty.

PURPOSE: Silent cerebral infarctions (SCI), as determined by neuron-specific enolase (NSE) elevations, may develop after the transcatheter aortic valve implantation (TAVI) procedure. Our aim in this study was to compare the SCI rates between patients who underwent routine pre-dilatation balloon aortic valvuloplasty (pre-BAV) and patients who underwent direct TAVI without pre-BAV. METHODS: A total of 139 consecutive patients who underwent TAVI in a single center using the self-expandable Evolut-R valve (Medtronic, Minneapolis, Minnesota, USA) were included in the study. The first 70 patients were included in the pre-BAV group, and the last 69 patients were included in the direct TAVI group. SCI was detected by serum NSE measurements performed at baseline and 12 h after the TAVI. New NSE elevations > 12 ng/mL after the procedure were counted as SCI. In addition, SCI was scanned by MRI (magnetic resonance imaging) in eligible patients. RESULTS: TAVI procedure was successful in all of the study population. Post-dilatation rates were higher in the direct TAVI group. Post-TAVI NSE positivity (SCI) was higher in the routine pre-BAV group (55(78.6%) vs. 43(62.3%) patients, p = 0.036) and NSE levels were also higher in this group (26.8 ± 15.0 vs. 20.5 ± 14.8 ng/ml, p = 0.015). SCI with MRI was found to be significantly higher in the pre-BAV group than direct TAVI group (39(55.1%) vs. 31(44.9%) patients). The presence of atrial fibrillation and diabetes mellitus (DM), total cusp calcification volume, calcification at arcus aorta, routine pre-BAV and failure at first try of the prosthetic valve implantation were significantly higher in SCI (+) group. In the multivariate analysis, presence of DM, total cusp calcification volume, calcification at arcus aorta, routine pre-BAV and failure at first try of the prosthetic valve implantation were significantly associated with new SCI development. CONCLUSIONS: Direct TAVI procedure without pre-dilation seems to be an effective method and avoidance of pre-dilation decreases the risk of SCI development in patients undergoing TAVI with a self-expandable valve.