Aim: To study different developmental profiles and auditory perception in a representative group of children with language impairment (LI). Methods: A multidisciplinary investigation was carried out in a group of 25 children attending units specifically for language‐impaired children. An assessment of the cognitive level, motor performance, behaviour and auditory perception was performed and the results were compared with those for age‐matched groups of children. Results: Among those with moderate or severe language impairment (LI), around 90% had additional developmental disorders. In three tests of auditory perception, children with LI had problems with working memory and speech discrimination. No problems were found with the children's temporal resolution in auditory perception. Another conclusion from the auditory perceptual tests was that the children's cognitive abilities were important for their success in these tests.
Conclusion: Neurodevelopmental deviations are very common in LI children. The optimal route for the assessment and treatment of these children would be a multidisciplinary approach.
Objective: We aimed to describe the risks of health care workers (HCWs) getting COVID-19, and analyze the transmission routes and dynamics of the infection. Methods: This is a prospective observational study. We screened 624 HCWs from April 1 to May 15, 2020, in a hospital with 300 hospital beds, in Istanbul, Turkey. All the HCWs working at high-risk areas (COVID wards, emergency departments, and intensive care units) were routinely screened every four weeks. The HCWs were grouped as high, moderate, low and none according to their risk of infection. Results: Out of 1300 total HCWs, 42 (3.2%) were diagnosed as COVID-19, 39 (3%) were confirmed by polymerase chain reaction (PCR) test. Among 42 symptomatic cases, 26 (62%) HCWs were hospitalized, mainly because of isolation needs, 62% received hydroxychloroquine (HCQ) alone, 11.5% HCQ + azithromycin, and 11.5% favipiravir only. All survived. We detected nine asymptomatic cases out of 550 HCWs (1.6%) in our screening for antibody levels. In none of the nine asymptomatic HCWs, SARS-CoV-2 RNA was not detected by PCR. In multivariate analysis for detecting the risk factors of the SARS-CoV-2 infection, working in high-risk areas (OR:5.2, CI:1.99-13.6, p=0.001), and not to use proper personal protective equipment (PPE) (OR:5.9, CI:1.66-21.2, p=0.006) increased the risk of infection. Conclusion: Routine screening of asymptomatic HCWs with antibody tests might be useful, but its effectiveness was limited. The HCWs working in high-risk areas had significantly higher risk. The strict use of appropriate PPE was effective in prevention.
The most common benign tumor of the brain is meningiomas. Usually diagnosed between the ages of 40–60, they are more common in women. Studies have shown a strong relationship between hormones and malignancies. Although meningiomas are slow-growing tumors of the brain, pregnancy seems to induce its growth speed. Studies concerning meningiomas and hormone relationship may explain the reason why symptoms during pregnancy flare. More specifically, the estrogen and progesterone receptor may take an active role through signal transduction in inducing the growth of the tumor. Thus, the dilemma of pregnancy + meningioma arises. In this case, a 21-year-old pregnant with a giant meningioma diagnosed on the symptom of loss of sight is reported. Her pregnancy was terminated, and the tumor was excised. Her vision improved and the histopathological examination showed a progesterone receptor positive meningioma. It is a challenging decision to be made by the physician, the patient and the family when deciding if and when pregnancy should be terminated once an intracranial meningioma is diagnosed.
In this research, the effect of tadalafil, a selective inhibitor of cyclic guanosine monophosphate-specific phosphodiesterase type 5, on rats with spinal trauma was evaluated. The evaluation consisted of neurological examination and biochemical parameters. Twenty healthy male Wistar albino rats were used in this study. They were separated into three groups: tadalafil-receiving (TD) group (n=7), laminectomy and trauma (LT) group (n=7), and just laminectomy group (n=6). The TD group received daily dose of tadalafil (10 mg/kg) for a week along with bait and water. Each rat's spinal cord was dissected with utter caution. The spinal cord was traumatized by Allen's weight-drop method. Using a standard apparatus, 5 g of weight was dropped from a height of 10 cm on the spinal cords of the TD and LT (laminectomy+trauma) group. No extra maneuvers were conducted on the laminectomy group. A day later, the rat's functional neurological status was examined followed by re-exploration of the spinal cord for sampling 1 cm of tissue. The Tarlov scale was used to evaluate the functional neurological status. The modified Tarlov scale was rated to be significantly higher in the TD group than that in the LT group. For the biochemical parameters, malondialdehyde (MDA) and cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) involved in the inflammatory process were examined. MDA--an indicator of lipid peroxidation--was found to be significantly lower in the TD group compared with that in the LT group. TNF-α and IL-6 levels were also found to be lower in the TD group compared with those in the LT group. Shortly, this research showed that the use of TD group in spinal trauma resulted in better neurological outcome and significant improvement in biochemical parameters.
Objective: We aimed to demonstrate the benefits of implementing a clinical pathway to decrease the inappropriate use of antibiotics in upper respiratory tract infections (URTI) in an emergency department (ED). Methods: The study was performed in a hospital with 300 beds. All patients who applied with URTI from 1st to 30th of April 2017 were included and the appropriateness of the antibiotics were compared with the patients in the same period in 2016. A checklist for the clinical pathway of URTI was completed by the ED physicians. Results: 351 patients were included, 176 these patients were in pre-ASP period and 175 patients were in post-ASP period. The rate of prescriptions including antibiotics was 49% in pre-ASP period and has decreased to 29% in post-ASP period (p < 0.001). Adherence to clinical pathway has increased from 50% to 80% (p < 0.001). In the post-ASP period, clinical pathway was used in 133 out of 175 patients (76%) and the consequently rate of appropriate antibiotic use was 82%. Conclusion: The implementation of clinical pathway for URTI has decreased inappropriate antibiotic use in ED. As the secondary effect, using clinical pathway in ED also has increased the awareness of ED physicians who did not adhere to clinical pathway.
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