Investigation of an alternative education module in raising middle school student's awareness of acute stroke.

INTRODUCTION: Public knowledge and recognition of stroke and prompt calls to ambulance services when stroke is suspected are vital to the survival of stroke patients and to minimize their disability. In this study, our aim was to investigate the effectiveness of an online education session to increase middle school (11-14-year-old) students' awareness of stroke. METHODS: An interactive education session was organized for students using the online education portal of a local middle school. The effectiveness of this intervention was measured using knowledge measurement tests before, immediately after, and three months after the session. The compliance of the data with the normal distribution was checked with the Kolmogorov-Smirnov test. The McNemar chi-square analysis was used to compare the distribution of correct and incorrect answers among the tests, and one-way analysis of variance was conducted to compare the mean values of correct answers. RESULTS: The students' stroke knowledge levels were found to be higher in both tests applied after the educational session and all the questions compared to the baseline evaluation. Stroke awareness was also determined to be higher among the students living with a family member aged over 65 years. CONCLUSIONS: Online interactive education can increase students' awareness of stroke. Such programs can be included in the education curriculum of schools. Public awareness of vital diseases should continue even in extraordinary situations, such as pandemics.

Working memory improvement after transcranial direct current stimulation paired with working memory training in diabetic peripheral neuropathy.

Association of cognitive deficits and diabetic peripheral neuropathy (DPN) is frequent. Working memory (WM) deficits result in impairment of daily activities, diminished functionality, and treatment compliance. Mounting evidence suggests that transcranial Direct Current Stimulation (tDCS) with concurrent working memory training (WMT) ameliorates cognitive deficits. Emboldening results of tDCS were shown in DPN. The study aimed to evaluate the efficacy of anodal tDCS over the left dorsolateral prefrontal cortex (DLPFC) coupled with cathodal right DLPFC with concurrent WMT in DPN for the first time. The present randomized triple-blind parallel-group sham-controlled study evaluated the efficacy of 5 sessions of tDCS over the DLPFC concurrent with WMT in 28 individuals with painful DPN on cognitive (primary) and pain-related, psychiatric outcome measures before, immediately after, and 1-month after treatment protocol. tDCS enhanced the efficacy of WMT on working memory and yielded lower anxiety levels than sham tDCS but efficacy was not superior to sham on other cognitive domains, pain severity, quality of life, and depression. tDCS with concurrent WMT enhanced WM and ameliorated anxiety in DPN without affecting other cognitive and pain-related outcomes. Further research scrutinizing the short/long-term efficacy with larger samples is accredited.

Greater occipital nerve block is an effective treatment method for primary headaches?

OBJECTIVES: Headache is one of the most common health problems, and it severely reduces the quality of life. The present study examines the efficacy of greater occipital nerve (GON) block in patients monitored for primary headaches. METHODS: The present study includes 53 patients monitored by the headache outpatient clinic from March 2017 to June 2018, evaluates them for headache type, attack duration, attack frequency, severity of pain, and analgesic intake and compares the initial values with the follow-up values at months 1, 3, and 6. RESULTS: The study group comprises 36 episodic migraine cases, 12 tension-type headache (TTH) cases, 4 chronic migraine cases, and 1 cluster headache case. In migraine group, VAS scores, attack durations, and the mean value of monthly number of attacks and analgesics taken significantly decrease compared to initial values at the end of the 6-month follow-up period. In TTH group, VAS scores, attack durations, and the mean value of monthly number of attacks and analgesics taken significantly decrease compared to initial values at the end of the 3-month follow-up period. Since only 2 of 12 patients completed the 6-month follow-up, although there was a decrease in the 6-month data, it was found to be statistically insignificant. CONCLUSION: Repetitive GON block is an effective treatment method for migraine and TTH.

Cancer-Associated Retinopathy in Patients with Newly Diagnosed Breast Tumor.

INTRODUCTION: Paraneoplastic neurological syndromes (PNS) are rare neurological conditions and they are mostly triggered by autoimmune mechanisms. Cancer-related retinopathies (CAR) are even rarer and commonly related with breast tumor in woman. This limits our knowledge about pathophysiology of CAR. In this study, we question the association between histopathological findings and onconeural antibodies in breast cancer. METHOD: Thirty-two patients with newly diagnosed breast cancer admitted to the oncology outpatient clinic were included in the study. None of the participants have visual complaints. After the neurological examination of the patients, two tubes of 5 cc venous blood were obtained by screening onconeuronal antibodies. Samples were investigated in ASDETAE (Istanbul University Experimental Medicine Research Institute). RESULTS: Patients included in the study included one patinet (3.1%) with grade 1, 14 patients (43.8%) with grade 2 and 17 patients (53.1%) with grade 3 invasive breast cancer. Perineural invasion was detected in 5 (15.6%) patients. Progesterone receptor positivity was found in 26 (81.2%) patients and estrogen receptor positivity was found in 27 (84.4%) patients. In 7 (21.9%) patients, CERBB2 was positive and in 25 (78.1%) patients, Ki 67 was positive. A total of 12 (37.5%) patients had onconeuroneal antibody positivity. Antibody positivity was significantly higher in patients with high grade tumor (p=0.008). CONCLUSION: There may be a relationship between tumor grade and the presence of onconeuronal antibodies in breast cancer patients. By the detection of new biochemical markers, significant contribution can be made to the early diagnosis and treatment of underlying cancer.

The association between temperament features and childhood traumas in patients with juvenile myoclonic epilepsy

Background/aim: Epilepsy is a common chronic neurological problem that impairs daily activities, functionality, and quality of life. Childhood traumas (CTs) are known to be critical factors in the onset or development of many psychiatric and medical disorders. They also play a critical role in the development of temperament and personality. This study aimed to investigate the association between CTs and common temperament patterns and features seen in epilepsy patients. Materials and methods: The study included 38 patients who were diagnosed with juvenile myoclonic epilepsy (JME) and volunteered to participate in the study. In addition to the sociodemographic form and questions on disease features, Structured Clinical Interview for DSM-IV Axis I Disorders, Temperament Evaluation of Memphis, Pisa, Paris and San Diego Questionnaire (TEMPS-A), Childhood Trauma Questionnaire (CTQ), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were administered to all participants. In the present study, a cut-off value of 35 was used for the CTQ scale. The patients with CTQ scores lower than 35 (50%, n = 19, Group 1) and the patients with CTQ scores above 35 (50%, n = 19, Group 2) were compared. Results: The comparison of TEMPS-A and its subscale scores in the JME patients in the groups with CTQ scores above or below a cut-off value detected significant differences between the groups in depressive and irritable temperament scores. The mean BDI scores were also different between the two groups. Furthermore, a significant positive correlation was detected between the disease duration, anxiety, and depression scores in the JME patients. A significant relationship was detected between the emotional neglect subscale score of the JME patients and the BDI scores. A significant positive correlation was found between the total disease duration, BDI, and BAI. Significant moderate-level relationships were found between the BDI score and irritable, depressive, cyclothymic, and anxious temperaments and between the BAI score and irritable, depressive, cyclothymic, and anxious temperaments. Conclusion: Several temperamental features of JME patients are related to CTs. More depressive symptoms are seen in JME patients with higher disease durations.

Mitochondrial depletion in CD4+ and CD19+ peripheral lymphocytes in early stage Alzheimer's disease.

Alzheimer's disease (AD) may be associated with mitochondrial defects. The aim of the present study was to investigate changes in mitochondrial abundance in peripheral lymphocytes of early and late stage AD patients. We analysed levels of mitochondrial DNA (mtDNA) and mean fluorescence intensity (MFI) of the mitochondria-specific antibody 113-1 in CD4+, CD8+, CD19+ and CD56+ peripheral lymphocytes of early and late stage AD by quantitative real-time PCR and flow cytometry, respectively. In early stage AD, the levels of mtDNA were significantly decreased in CD4+, CD19+ and CD56+ peripheral lymphocytes while the MFI of 113-1 staining was significantly decreased in CD4+ and CD19+ cells. Thus, CD4+ and CD19+ peripheral lymphocytes of early stage AD patients exhibit mitochondrial depletion, as seen both at the level of DNA and protein.