Our aim was to compare the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) over supplementary motor area with that of sham stimulation in restless legs syndrome (RLS). In this prospective study, patients were randomly assigned to either real stimulation group (11 patients), or sham stimulation group (8 patients) in a double-blinded fashion. Five patients, who were initially in the sham stimulation group, received real stimulation 1 month after the sham stimulation. One session of intervention was performed once every 3 days and total of ten sessions were done in each group. The International RLS-Rating Scale (IRLS-RS) was assessed at baseline and after 5th and 10th sessions in both groups and also in five patients in whom both sham and real stimulation were performed. A statistically significant difference was seen in the IRLS scores between real (n = 11) and sham stimulation (n = 8) after 5th and 10th sessions. The real stimulation significantly improved the IRLS-RS scores although they were unaffected by the sham stimulation. In five patients, in whom both sham and real stimulation were performed, a statistically significant improvement was seen in the IRLS-RS scores with the real stimulation and a statistically significant difference was seen in the IRLS scores between real and sham stimulation after 10th session. In conclusion, this method is safe and non-invasive, and the results of this pilot study may support that rTMS has the potential to be used in the treatment of RLS, which should be verified in larger series.
Our findings indicate that open drainage leads to better results compared to those of Eloesser flap in patients with chronic tuberculous empyema. Patients who underwent pneumonectomy were expected to have higher complication rates and the procedure must therefore be avoided when possible.
Central venous catheters are frequently used for different causes, like fluid infusions, haemodialysis, and measurement of central venous pressure. Complications that occur at the time or after the placement of these catheters can give harm to the patient or can cause need for a new attempt. Complications, like malfunction of the catheter, arterial puncture, haemothorax, or pneumothorax, can be seen in 5%-26% of the patients, and early detection is very important. We want to present a venous perforation and lung injury case according to the catheter based upon the literature.
Is headache only headache? Comorbidity of headaches and mental disordersObjective: To determine the psychiatric disorders comorbid with headaches and the characteristics of these disorders. Method:Patients who admitted to the neurology outpatient clinic with a main complaint of headache (n=71), and the same number of patients matching with age and sex (n=71) who admitted to the psychiatry outpatient clinic and had a non-psychotic diagnose in axis I were included into the study. Socio-demographic data and information about their headaches were obtained from all patients. The Visual Analog Scale and MINI-scan form were obtained and psychiatric diagnoses were made after the assessment by MINI.Results: There was not any difference between headache and psychiatric patients group in terms of sociodemographic data. Headache history was found higher in the families of headache group than the psychiatric patients group. High prevalence of psychiatric comorbidity was found in patients with headache (80.3%). All of the patients with tension-type headache (TTH) fulfilled the criteria for diagnosing a pain disorder by MINI, and also the high prevalence of psychiatric comorbidity (63.4%) was still taking place after excluding the pain disorder. The most frequent diagnose of psychiatric comorbidity was found as depressive disorders (64.8%) which is compatible with the literature.Discussion: The high prevalence of psychiatric comorbidity with headache is remarkable. More common family history of headache in headache patients than the other group suggests that there is a tendency to have headache independent from a psychiatric disorder in these patients. High comorbidity rate in the presence of psychosocial stressors suggests that there is a continuum among psychiatric comorbidity, headache and psychosocial stressors.Among the psychiatric comorbidity, depressive disorders predominate. On the other hand, the higher frequency of psychiatric comorbidity in patients with TTH is remarkable. It is observed that the uncertainty between the diagnostic criteria of pain disorder in DSM-IV and diagnostic criteria of TTH (Tension Type Headache) in ICHD (International Classification of Headache Disorders) causes some problems both in diagnosing and treatment of patients and also in researches. Tartışma: Baş ağrısı hastalarında psikiyatrik eş tanı yüksekliği dikkat çekicidir. Hastaların ailelerinde baş ağrısı öyküsünün belirgin olarak daha çok olması, kişide psikiyatrik bir sorun varlığından bağımsız bir baş ağrısı eğilimini işaret etmektedir.Psikososyal stresör varlığında yüksek eş tanı oranlarının olması, psikososyal stresör, psikiyatrik eş tanı ve baş ağrısı arasında bir süreklilik olduğunu göstermektedir. Psikiyatrik eş tanılar arasında depresif bozukluklar (depresyon) ağırlık taşımaktadır. Öte yandan araştırmamız gerilim tipi baş ağrısı hastalarındaki psikiyatrik eş tanı yüksekliğine dikkat çekmektedir. DSM-IV'teki ağrı bozukluğu tanı ölçütleri ile ICHD (International Classification of Headache Disorders) gerilim tipi baş ağrısı...
ÖZET GİrİŞAnestezi ve cerrahideki gelişmelere rağmen, pnömo-nektomi ameliyatına bağlı komplikasyon oranları % 50'e kadar yükselebilmektedir. Bu komplikasyonlar kardiyak herniasyon, hemoraji, pnömotoraks, şilo-toraks, atelektazi, mediastinal kayma, bronkoplevral fistül, ampiyem, postoperatif pnömoni, postpnömo-nektomi sendromu, pulmoner ödem, aritmi, pulmoner emboli, miyokard infarktüsü gibi çok çeşitli olabilir [1] . Pnömonektomi sonrası mortalite oranları ise % 5-13 arasında değişmekte olup; sağ pnömonektomi sonrasında daha fazladır. Mortalitenin en sık nedeni postoperatif aritmi ve akut akciğer hasarıdır [1][2][3] .Pnömonektomilerden sonrası ender olarak mediastenin aşırı kayması ile ana bronş aorta, pulmoner arter veya vertebra arasında sıkışabilmektedir. Bu ender bir postpnömonektomi komplikasyonu olup; genellikle geç dönemde gelişir. Sağ pnömonektomi sonrasında, mediastenin aşırı kayması ve trakea ile pulmoner damarların saat yönünün tersine dönmesi, sol ana bronşun anteriorda pulmoner arter, posteriorda desendan aorta arasında sıkışmasına neden olmaktadır. Sol pnömonektomi sonrası da gelişebilen bu klinik tabloda sağ ana bronş ve pulmoner damarlar, saat yönünde dönerek, anteriorda yine pulmoner arter, posteriorda ise vertebra arasında sıkışmaktadırlar [4,5] .Sol pnömonektomi sonrası erken dönemde mediasAlındığı tarih:
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