Neurological Face of Familial Mediterranean Fever.

OBJECTIVE: Familial Mediterranean fever is a systemic inflammatory disease characterized by recurrent attacks in the form of fever and inflammation of serous membranes. We aimed to search for neurological signs and symptoms of children with familial Mediterranean fever. MATERIALS AND METHODS: Medical records database from 2010 to 2020 was screened retrospectively. In total, 625 children with familial Mediterranean fever were included in the study. Neurological symptoms and associated factors were searched. RESULTS: The mean age at onset of familial Mediterranean fever symptoms and time to diagnosis was calculated as 5.12 ± 3.51 years and 7.27 ± 3.9 years, respectively. The neurological symptoms were present in 142 (23.5%) patients. Headache was the most common symptom. During follow-up, different neurologic diseases were diagnosed in 40 familial Mediterranean fever patients and epilepsy was the most frequent disease. The coexistent disease was present in 49.9% of children with familial Mediterranean fever. Juvenile idiopathic arthritis was found to be a risk factor for the neurologic symptom (P < .05). The frequency of neurological symptoms was higher in patients with E148Q mutation (P < .012). CONCLUSION: The results of the present study revealed that patients with familial Mediterranean fever can present with various central nervous system manifestations. A multidisciplinary approach must be considered in the treatment of these children.

Use of a modified surgical APGAR score for prediction of postoperative complications in emergency surgery: An observational retrospective study.

BACKGROUND: The surgical Apgar score (SAS) was defined by Gawande et al. in 2007. It has been shown that this scoring system was highly effective for predicting the incidence of post-operative complications and mortality. In this study, we aimed to define a new, modified SAS (mSAS) for predicting the incidence of post-operative complications and mortality in emergency surgery. We also wanted to quantify the effectiveness of this modified scoring system, comprising of the duration of the operation in addition to the three intraoperative parameters of the SAS score. METHODS: Five hundred and seventy-nine patients who underwent emergency surgery were enrolled in this retrospective obser-vational study. At the end of the operation, the SAS was calculated from the data obtained from the examination of the patients and the mSAS was calculated by adding the duration of the operation to data used in the calculation of the SAS (Surgical duration >8 h; -4 points; 7.01-8 h; -3 points; 5.01-7 h; -2 points; 3.01-5 h; -1 points; 0-3 h; 0 points added). RESULTS: There was a statistically significant relationship between the mSAS and the total number of complications (as operative time [OT] increased, the number of complications increased) (r=0.360; p=0.001). The compliance levels of the SAS and mSAS were 98.4% and they have been found as statistically significant (ICC: 0.984; p=0.001; p<0.01). CONCLUSION: We suggest that the OT should be included as a simple, objective and practical indication of the SAS risk score in major operations. The mSAS was an independent predictor of post-operative mortality and complications. With the widespread use of electronic medical record systems and the effective use of pre-operative medical data, the mSAS can be used as an easy and new scoring system to predict prognosis.

Burnout Syndrome During Residency.

OBJECTIVE: The aim of this study is identified the degree of Burnout Syndrome (BOS) and find out its correlation with years of recidency and sociodemograpfic chareacteristics, training, sleeping habits, such as smoking and alcohol consumption. METHODS: After approval from the Hospital Ethics Committee and obtaining informed consent, First, second, third, fourth and fifth year of recidency staff (n=127) working in our hospital were involved in this study. The standardized Maslach Burnout Inventory (MBI) was used in this study. RESULTS: Fifty six male (44.1%) and seventy one female (55.9%) residents were enroled in this study (Coranbach Alfa(α)=0.873). 57% of the first year residents smokes cigaret and 54% of them use alcohol. 2% of them gets one day off after hospital night shift, 61% of them suffers from disturbed sleep. 60% of them had been stated that they willingly selected their profession. 61% of them prefers talking to friends and 32% of them prefers shopping to overcome stress. There were statistical difference acording to years of recidency in MBI, Emotional Burnout (EB) and desensitisation scale (DS) points. EB scale points of the second year of residency group was statisticaly higher than fourth year of residency group. DS points of second year of residency group was also statisticaly higher than the third and fourth year of residency group. There was no statistical difference between any groups in Personal Success. CONCLUSION: BOS is a frequent problem during residency in anaesthesia. Appropriate definition and awareness are the first important steps to prevent this syndrome. Further administrative approaches should be evaluated with regard to their effects.