Serkan Demir

First report of macroscopic biofilm formation caused by Candida albicans on silver hydrogel–coated urinary catheters

We report macroscopic biofilms on silver hydrogel-coated urinary catheters in 2 patients from 2 different intensive care units. The catheters were removed on observation of a white, jelly layer on the catheters, respectively, 9 and 21 days after insertion. Yeast cells and pseudohyphal structures were observed with microscopy. Both isolates were identified as Candida albicans. To our knowledge, these are the first cases demonstrating the formation of macroscopic biofilm layers on silver nitrate-coated catheters in the literature.

Reliability, validity and validation of the CNS emotional lability scale for pseudobulbar affect on multiple sclerosis in Turkish patients

ABSTRACT INTRODUCTION: Pseudobulbar affect (PBA) is described as uncontrolled, unprovoked outbursts of laughing and/or crying not related to the patient’s underlying emotion or experience. PBA may be overlooked or underdiagnosed and so an effective method of evaluation is important. The Center of Neurologic Study-lability Scale (CN-LS) is such a self-report Likert scale consisting of seven questions on laughing and crying. METHODS: The study was done to carry out the validity and reliability studies in Turkish for this test and validate it for multiple sclerosis (MS). For the content validity of the scale, one measurement and evaluation expert and five experts on the subject were interviewed. After a pilot study to evaluate the clarity of the scale, the reliability of the test was determined by sampling 154 normal and 56 MS patients, testing and retesting. RESULTS: Test–retest correlations were high (Pearson correlation coefficient = 0.99, n = 56, p = .000). Also, there was no statistically significant difference between the means by using dependent sample t-test analysis (t = 0.40, n = 210, p = .69). In order to reveal the internal consistency of the test, the Cronbach alpha coefficient, another reliability test, was calculated and found to be high (α = 0.83, n = 210). For validation of the scale for MS, a separate study was conducted on 63 patients and ROC (receiver operating characteristic) analysis for criterion validity was performed. To define the cut-off score at or above which an individual with MS can be diagnosed as having PBA, one physician performed the test while the other independently stated his impression on the presence of the condition and the two scores were compared using the ROC analysis. The ROC curve analysis for the criterion validity was found to be very high (area under the curve = 0.976, p = .000). Using sensitivity and specificity calculations, the best acceptable cut-off score turned out to be 14.5 as being positive for PBA in Turkish MS patients. CONCLUSION: Timely and appropriate evaluation of PBA is important in MS and the CNS-LS is a robust test instrument that has been used to assess PBA in different neurological conditions including MS. This condition has been known to influence the quality of life of patients. So after this study of validity, reliability, and validation, we hope it will be routinely used for evaluation.

Spectral Domain Optical Coherence Tomography Findings in Carotid Artery Disease

Objectives: To evaluate the effect of carotid artery disease on retinal morphology by means of spectral domain optical coherence tomography (SD-OCT). Materials and Methods: We examined 23 eyes with internal carotid artery (ICA) stenosis and 24 age- and gender-matched healthy eyes as a control group in this prospective, case-control study. Compherensive ophthalmic examination and SD-OCT scan were performed to all the patients. The average RNFL and macular thicknesses (MT) in the nine macular ETDRS areas were the major OCT measurements for our study. Results: Although all of the average RNFL and MT measurements were lower in the ICA stenosis group, only the total MT and outer ETDRS area (temporal/superior/nasal/inferior outer macula) values were found to be significantly thinner compared to the control group (p=0.004, p=0.009, p<0.001, p=0.002, and p=0.001, respectively). Conclusion: In addition to our knowledge about the effects of ICA stenosis on the retino-choroidal circulation, we found that OCT measurements may be beneficial in the early detection of ocular damage due to ICA stenosis.

A Rare Case of Neurocysticercosis with an Isolated Central Nervous System Involvement in Turkey

Neurocysticercosis (NCC) is frequently seen in Latin America, South East Asia and Africa, it is rare in Western Europe and Muslim countries. This case report is found to be valuable for presentation due to isolated CNS involvement of NCC, high cystic lesion load and resistance to the antihelmintic agents. NCC is rare in Muslim countries, it should be considered in differential diagnosis of the patients with cystic lesions in CNS.