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Objective: The aim of this study was to evaluate the effectiveness of the maternal voice in reducing pain during painful procedures in children between one and three years old receiving treatment in paediatric intensive care unit. Design and methods: This research was designed as a randomised controlled experimental study. Sixty children were randomised into two groups, the maternal-voice group and the controls. The children in the maternal-voice group listened to the maternal voice during the procedure. Although questionnaire forms were used to determine the descriptive characteristics of infants, the Face, Legs, Activity, Cry, Consolability (FLACC) pain assessment scale was used to evaluate pain level. Heart rate and oxygen saturation were also measured. Results: There were significant differences in the pain, heart rate and oxygen saturation levels between the maternal-voice and control groups. Pain levels and heart rates of the children in the experimental group during and after the painful procedures were much lower, and their oxygen saturations were higher than those of the children in the control group. Practic implications: Distraction methods, such as listening to the maternal voice, should be used as a nursing intervention to reduce pain and decrease heart rate and increaseoxygen saturation in children during painful procedures in the paediatric intensive care unit. The maternal voice is recommended as a helpful option in cases when a pain control method is required. Future research needs to explore different interventional practices. (C) 2019 Elsevier Ltd. All rights reserved. C1 [Erdogan, Cigdem; Turan, Turkan] Pamukkale Univ, Fac Hlth Sci, Pediat Nursing Dept, Denizli, Turkey. [Pinar, Bakiye] Pamukkale Univ, Pamukkale Univ Hosp, Pediat Intens Care Unit, Denizli, Turkey.

Background: Fathers whose infants are cared for in the neonatal intensive care unit have negative experiences and thus require support. Aim: This study was carried out with the aim of performing a validity and reliability study of the Turkish version of the "Father's Support Scale: Neonatal Intensive Care Unit" (FSS: NICU). Method: The study included 165 fathers whose infants were hospitalised in the neonatal intensive care units of a university hospital and a state hospital in the west of Turkey. Findings: The item-total score correlation values of the scale were between 0.26 and 0.73 and the Cronbach's alpha coefficient was 0.91. It was found out that the test-retest reliability coefficients were between 0.78 and 0.92. The scale accounted for 48.38% of the total variance in three factors, as in the original version of the scale. Conclusion: It was found that the Turkish version of the FSS: NICU was a valid and reliable measurement tool. (C) 2018 Elsevier Ltd. All rights reserved. C1 [Turan, Turkan; Erdogan, Cigdem; Ceylan, Sibel Serap] Pamukkale Univ, Pediat Nursing Dept, Fac Hlth Sci, Denizli, Turkey.

The aim of this study was to search for the frequency of late onset Pompe disease (LOPD) among patients who had a myopathy with unknown diagnosis registered in the pre-diagnostic part of a novel registry for LOPD within a collaborative study of neurologists working throughout Turkey. Included in the study were 350 patients older than 18 years who have a myopathic syndrome without a proven diagnosis by serum creatine kinase (CK) levels, electrodiagnostic studies, and/or muscle pathology, and/or genetic tests for myopathies other than LOPD. Acid alpha glucosidase (GAA) in dried blood spot was measured in each patient at two different university laboratories. LOPD was confirmed by mutation analysis in patients with decreased GAA levels from either both or one of the laboratories. Pre-diagnostic data, recorded by 45 investigators from 32 centers on 350 patients revealed low GAA levels in a total of 21 patients; from both laboratories in 6 and from either one of the laboratories in 15. Among them, genetic testing proved LOPD in 3 of 6 patients and 1 of 15 patients with decreased GAA levels from both or one of the laboratories respectively. Registry was transferred to Turkish Neurological Association after completion of the study for possible future use and development. Our collaborative study enabled collection of a considerable amount of data on the registry in a short time. GAA levels by dried blood spot even from two different laboratories in the same patient may not prove LOPD. LOPD seemed to be rarer in Turkey than in Europe. (C) 2017 Elsevier B.V. All rights reserved.

Purpose: Sudden infant death syndrome is the most common cause of death during the post-neonatal period. Factors such as sleeping position, bed sharing, pillow use, smoking during pregnancy and the breastfeeding period constitute risk factors for sudden infant death syndrome. This study aims to identify the risky behaviors of mothers with infants that may put their children at risk for sudden infant death syndrome. Design and methods: This is a cross-sectional, descriptive study. Data were collected using a questionnaire that was developed by the researchers. The questionnaire was filled out by 456 mothers who applied to the family health center between October 2014 and January 2015. Results: The greatest risk factor is the infant's sleeping position. A total of 77.9% of the mothers put their babies in bed in a non-supine position; 65.8% used a pillow when they put their babies in bed, 52.9% used a soft mattress, and 28.5% shared their beds with their babies. Prone sleeping was more likely to occur when smokewas present in the home or a pillow was used. Conclusion: Nurses should notify families of the risky behaviors that can cause sudden infant death syndromeand plan appropriate nursing care. (c) 2017 Elsevier Inc. All rights reserved.

Objectives - Depression and anxiety are frequent in patients with chronic diseases such as diabetic neuropathic pain. The pain seems to be more severe in patients in whom depressive findings accompanied pain symptoms. Pregabalin was reported to have positive effects on anxiety and depression. This brings out the question, whether the pain relief effect of pregabalin is due to its analgesic effect or to its effects on mood? The aim of this study is to find out whether the positive effect of pregabalin in patients with diabetic neuropathic pain is limited to its effect on pain. Thus the question do patients suffer from less pain or do they less care about pain? should be answered. Methods - With this aim the NRS scores of 46 patients with diabetic neuropathic pain, whose HADS scores did not change with pregabalin treatment were compared with their baseline levels, retrospectively. Results - The NRS scores of the group were reduced with pregabalin treatment. Conclusion - This results suggests that the reduced pain in pregabalin treatment should be independent from its effects on depression and anxiety.

Objectives: This study aims to estimate the prevalence of rheumatoid arthritis (RA) and spondyloarthritis (SpA) in Turkey using the same telephone questionnaire developed for screening RA and SpA in France and used in Serbia and Lithuania. Material and methods: The study was performed in two steps. In step I, the French questionnaire was translated into Turkish and validated through a group of 200 patients (80 males, 120 females; mean age 44.0 +/- 13.1 years; range, 19 to 75 years) followed up at the rheumatology departments of University Hospitals in Antalya and Ankara. In step II, the validated Turkish questionnaire was administered face-to-face to randomly selected 4,012 subjects (1,670 males, 2,342 females; mean age 41.5 +/- 16.8 years; range, 16 to 97 years) by trained general practitioners across the country, in 25 provinces for case detection. The subjects who were suspected of having RA or SpA in accordance with the questionnaire were invited to the nearest university hospital for rheumatologic examination in order to confirm the diagnosis. Results: In step II, a total of 25 subjects (2 males, 23 females) were diagnosed as RA. The standardized RA prevalence for the general population of Turkey was calculated as 0.56% (95% confidence interval [CI]; 0.33-0.79), 0.10% (95% CI; -0.05-0.25) for males and 0.89% (95% CI; 0.51-1.27) for females. A total of 18 subjects (3 males, 15 females) were diagnosed as SpA. The standardized SpA prevalence for the general population of Turkey was 0.46% (95% CI; 0.25-0.67), 0.17% (95% CI; -0.03-0.37) for males and 0.65% (95% CI; 0.32-0.98) for females. The prevalence of RA was highest in the Northern region (2.00%) and the prevalence of SpA was highest in the Central region (1.49%). Conclusion: The prevalences of RA and SpA in Turkey are close to each other and there are significant inter-regional variations in prevalences of both RA and SpA.

Long QT syndrome is characterized by a prolongation of the QT interval resulting in a tendency to ventricular tachyarrhythmias, particularly Torsade de Pointes. Inhalational anesthetics are often accused of prolonged QT interval. Herein, we report a pediatric case of long QT syndrome with a persistent Torsade de Pointes episode under general anesthesia with sevoflurane during surgical implantable cardioverter-defibrillator placement. Recurrent Torsade de Pointes requiring electrical cardioversion were considered to be unrelated to the surgical management. These episodes were considered to be related to sevoflurane inhalation. After terminating sevoflurane, arrhythmias disappeared. As malignant arrhythmias may have detrimental results for patients, we conclude that inhalation anesthetics should be avoided in patients with long QT syndrome.

We aimed to assess the functional status, urinary problems, and awareness of these problems in adults with cerebral palsy (CP) and their relationship with the quality of life. One-hundred-seventeen adults with CP (53 women, 64 men) were included in this study. Subjects were asked to fill out a urological questionnaire which dealt with urinary symptoms, awareness of urinary problems, and pharmacological treatment they received. Subjects were also assessed with the Gross Motor Function Classification System (GMFCS), Functional Independence Measures (FIM), Functional Mobility Scale (FMS), and King's Health Questionnaire (KHQ). The mean age of the subjects was 25.3 +/- 7.8 years. Of the patients, 83.8% were currently unemployed, 95.7% were single, and 96.5% were living with family. Of the patients, 20.5% had experienced frequency, 38.5% had nocturia, 48.7% had urgency, and 36.8% had urge urinary incontinence. Approximately 80% of the patients did not refer to physician due to urinary problems, and 60% of patients were not recorded history about urinary problem by any physician. Urge urinary incontinence was statistically more frequent in females than males (54.7 and 21.9%,respectively, p < 0.05). Female patients had significantly higher KHQ incontinence impact, role limitation, physical limitation, emotion, incontinence severity measures, and symptom severity subgroup scores than male patients (p < 0.05). Urge urinary incontinence was most frequent (65.4%) in spastic quadriplegic CP (p < 0.05). All functional status scores (GMFCS, FIM-toilet transfer, and FMSs) were worse in spastic quadriplegic patients than other topographical involvement of CP (p < 0.0125). Although the urinary problems are common in adult with CP, it is yet an overlooked condition that could affect quality of life. Therefore, health care professionals, patients, and their caregivers should be aware of the increased risk of urinary problems in these patients.

Introduction:Acute myeloid leukemia (AML) is a hematological malignancy associated with life-threatening coagulopathy.All trans retinoic acid (ATRA) therapy is one of the treatment approaches of AML M3. Acute respiratory failuremay occur in patients receiving ATRA therapy, which require close monitoring for respiratory function inpatients receiving this medication.A 34 year old female admitted to intensive care unit with dsypnea. The patient have previous history of AMLM3. After first ATRA treatment, she suffered from hypoxia, respiratory failure and transfered to the intensivecare unit (ICU). Hemodialysis and plasmapheresis were applied alternately during the treatment for cytokineremoval. Mechanical ventilation and drug therapy were started.The patient's hemoglobin, Oxygen saturation and blood pressure returned to normal after mechanicalventilation support, antihypertensive therapy, nutritional support with Total Parenteral Nutrition, antibiotictherapy and erythrocyte suspension replacement therapy for low hemoglobin and hematocrit level.It should be considered that ATRA can cause respiratory problem such as life-threating Acute RespiratoryDistress Syndrome. Close monitoring and respiratory assessment must be done. Early intervention anddiscontinuation of ATRA may be life saving in this group of patients.

WOS: 000384561800053 …

Objective: To determine the relationship between central adiposity parameters and autonomic nervous system (ANS) dysfunction. Subjects and Methods: The study included 114 obese individuals without any cardiovascular risk factors. Weight (in kg), height (in m), and waist circumference (WC; in cm) were measured and body mass index was calculated. Echocardiographic examination was performed to measure left ventricular mass and epicardial fat thickness (EFT). All the participants underwent an exercise test and electrophysio-logical evaluation using electromyography. Heart rate recovery (HRR) at 1-5 min, R-R interval variation at rest and during hyperventilation, and sympathetic skin response were measured. Pearson's correlation analysis was used. Multiple linear regression analysis was used to identify the factors associated with autonomic dysfunction. Results: The HRR at 1-5 min was negatively correlated with WC and age (WC-HRR1: r = -0.32; WC-HRR2: r = -0.31; WC-HRR3: r = -0.26; WC-HRR4: r = -0.23; WC-HRR5: r = -0.21; age-HRR2: r = -0.32; age-HRR3: r = -0.28; age-HRR4: r = -0.41; age-HRR5: r = -0.42). Age was the only independent predictor of reduced HRR at 1-5 min. In addition, WC predicted a reduced HRR at 3 min. There were no significant associations between central obesity and electrophysiological parameters. EFT was not associated with ANS dysfunction. Conclusion: In this study, central adiposity and aging were associated with ANS dysfunction in obese individuals. The WC could be a marker of ANS dysfunction in obese individuals without any cardiovascular risk factors. The HRR assessment at a later decay phase could be more valuable for evaluating ANS function than during early recovery. (C) 2016 S. Karger AG, Basel

Fahr's syndrome is a neuropsychiatric syndrome characterized by symmetrical and bilateral intracerebral calcifications located in the basal ganglia and usually associated with a phosphorus and calcium metabolism disorder. Clinical manifestations of Fahr's syndrome vary; it may start at different ages and have a variety of presentations. This article discusses rare presentation of Fahr's syndrome with epileptic seizure. These cases are important because they appear to be the first cases in the literature of Fahr's syndrome presenting with generalized tonic clonic seizure.

This paper introduces the proof of concept of low-Earth-orbit satellite attitude determination using GNSS, mainly GPS satellite signals. Two methods are considered and compared in detail: carrier phase measurements and signal-to-noise ratio (SNR-RSS) method. A preliminary design to be used in testing the algorithms is explained, and results of simulations with RSS method are presented.

Benign episodic unilateral mydriasis is a descriptive situation with recurrent unilateral mydriasis in adult people especially women with migraine. A 20 year-old man who presented with paroxysmal left pupil mydriasis and diagnosed as benign episodic unilateral mydriasis after the examinations to exclude the other reasons of anisocoria was reported. In such cases to keep in mind the benign causes of mydriasis would be helpful to avoid unnecessary invasive tests

Objective: Cutaneous silent period (CSP) is an inhibitory spinal reflex and the afferent arm of this response involves A-delta nerve fibers. The aim of this study was to investigate CSP parameters in patients with type 2 diabetes mellitus (T2DM) and to examine the effects of alpha-lipoic acid (ALA) treatment on CSP. To the best of our knowledge, this investigation has not yet been carried out until date. Methods: Seventeen patients with T2DM and 23 healthy volunteers were studied. CSP latency and duration in the upper and lower extremities of both the groups were examined. In T2DM patients, the variables were examined before and after ALA treatment. Results: CSP latency in T2DM patients was longer than that in the controls. In the patient group, CSP latency in the upper and lower extremities and CSP Latency Differences (LD) shortened in the third month after treatment compared with the pre-treatment values. Conclusions: The results suggest that ALA treatment may alleviate small-fiber neuropathy in T2DM patients and that CSP may be a useful supportive tool to evaluate ALA treatment effectiveness.

Different nerve fibers may have disparate conduction parameters even though they are in the same peripheral nerve. Hyperglycemia can have differential effects on nerve fibers, depending on diameter. In diabetes, conventional nerve conduction studies have allowed us to classify a peripheral nerve as normal or not. But, there may be differential involvement in disparate nerve fibers of the same peripheral nerve. This study evaluated the effects of hyperglycemia on nerve fibers of peroneal nerve by diameter. Thirty-five diabetic patients with normal nerve conduction studies and thirty-two healthy controls were included to the study. The peroneal nerve was stimulated from two points (upper and below the fibula head) and recorded from the tibialis anterior (TA) and extensor digitorum brevis (EDB) muscles. Then the ratios of conduction velocity parameters recorded in these sides were compared between the diabetic and control groups. The conduction velocity recorded from EDB seemed to be faster in both groups. But there were no significant differences among the ratios between the groups. Our study has demonstrated the conduction parameters of two nerve fibers with different diameters in the peroneal nerve. The ratios of conduction parameters were similar in both groups, suggesting that fibers in the peroneal nerve are similarly affected by hyperglycemia.

The aim of this study was to demonstrate the prevalence of cerebrovascular disease (CVD), and its relation to age, education, gender, and other risk factors in the city of Denizli, Turkey. The study was performed between 2010 and 2011 in the city center, where 138,000 inhabitants[45 years were included in the research. 2,441 inhabitants were selected by cluster sampling method. A specific questionnaire about CVD was employed during the interview. We inquired about patient's age, gender, and educational history. If there was suspicion of CVD, cranial imaging was performed, and recent medical records were re-evaluated. The mean age was 58 +/- 10.1 (45-100) among 2,441 in this study. Of those, 1,257 (51.5 %) participants were female and 1,184 (48.5 %) were male. We found the prevalence of CVD to be 0.9 % with 0.68 % among males and 1.21 % among females (p = 0.023). The mean age of subjects with CVD was 72.4 +/- 8.1 (56-86) years. CVD was found to increase with age (p = 0.001), but was lower than reported rates in other European countries; however, it was similar to that of Mediterranean countries. CVD was detected more frequently in women than men. This finding differed from other studies, but was first to evaluate the prevalence of CVD in Turkey.

Objectives: Because of the well-known neurochemical interactions between the septum and hippocampus during memory processes, we investigated the effect of amyloid-beta (A-beta) injection into the medial septum (MS) on the behavior in Wistar rats. We also assessed whether the observed effects were functional or due to apoptosis. Methods: Specific A-beta oligomers (beta(1-40):beta(1-42) = 10: 1) were injected into MS for seven consecutive days. Behavior was assessed with the Morris water maze task. Results: Compared with the control group, rats that received A-beta oligomers exhibited significant memory retention impairment (P < 0.05) without apoptosis in the cornu ammonis (CA) 1 and CA3 regions of the dorsal hippocampus. Discussion: These data indicate that septal injection of A-beta impairs memory retention, even in the absence of hippocampal apoptosis. This result might bring new insight to spatial memory-related disorders like Alzheimer's disease (AD).

This study investigates the correlation between brain magnetic resonance imaging findings and blink reflex abnormalities in patients with relapsing remitting multiple sclerosis. Twenty-six patients and 17 healthy subjects were included in this study. Blink reflex test (BRT) results were obtained using right and left stimulations; thus, 52 BRT results were recorded for the patient group, and 34 BRT results were recorded for the control group. The magnetic resonance imaging (MRI) findings were classified based on the existence of brainstem lesions (hyperintense lesion on T2 weighted (W) and fast fluid-attenuated inversion recovery MRI or contrast-enhancing lesion on T1W MRI). Correlation analysis was performed for the BRT and MRI findings. The percentage of individuals with abnormal BRT results (including R1 latency, ipsilateral R2 latency, and contralateral R2 latency) was significantly higher in the patient group as compared to the control group (p values: 0.015, 0.001, and 0.002, respectively). Correlation analysis revealed significant correlations between contralateral R2 latency abnormalities and brainstem lesions (p value: 0.011). Our results showed significant correlation correlations between contralateral R2 latency abnormalities and brainstem lesions and these results may be explained the effects of multiple demyelinating lesions of the brain stem of patients with relapsing remitting multiple sclerosis.

In this study, we aimed to investigate habituation of pattern-reversal visually evoked potentials (VEPs) in patients with relapsing remitting (RR) multiple sclerosis (MS). Twenty-one patients with this diagnosis and with a history of optic neuritis (ON), 29 such patients without a history of ON, and 25 normal controls were enrolled to study. One eye of each patient in the group with a history of ON and one eye of each subject in the control group was randomly selected. In the group with a past history of ON, the affected eye of the patients was selected in unilateral cases and the eye in which showed the greater latency delay of the P100 component in bilateral cases. P100 amplitudes were determined by visual inspection in 10 blocks of 512 responses and habituation was analysed as the percentage amplitude change between the 1st and 2nd-10th blocks. Amplitude of the P100 component of the VEP showed a significant clear-cut habituation after the first block in the control group but neither patient group showed a significant decrease in P100 amplitude. We conclude that our electrophysiological study has shown a lack of habituation in patients suffering from RR MS. This result could be important for the evaluation of visual system involvement in patients with MS, with or without a previous history of ON.

The signs and symptoms of acute disseminated encephalomyelitis are heterogeneous and dependent on the location and severity of the inflammatory process. The meningoencephalitic presentation may include meningism, impaired consciousness (occasionally leading to coma), seizures and confusion, or behavioral disturbances. Multifocal neurological features include a combination of optic neuritis, visual field defects, cranial neuropathy, sensorimotor impairment, ataxia, aphasia, and involuntary movements. One definition of acute disseminated encephalomyelitis is "an initial clinical event with a presumed inflammatory and demyelinating cause, with acute or sub-acute onset affecting multifocal areas of the central nervous system". Patients with acute disseminated encephalomyelitis frequently suffer from seizures, disturbances of consciousness, fever, and headaches, and occasionally there are focal signs and symptoms. Here, we report on two cases who presented with different symptoms, but the clinical findings that the patients showed were benign.

OBJECTIVES: Because of the well-known neurochemical interactions between the septum and hippocampus during memory processes, we investigated the effect of amyloid-beta (A-beta) injection into the medial septum (MS) on the behavior in Wistar rats. We also assessed whether the observed effects were functional or due to apoptosis. METHODS: Specific A-beta oligomers (beta1-40:beta1-42 = 10:1) were injected into MS for seven consecutive days. Behavior was assessed with the Morris water maze task. RESULTS: Compared with the control group, rats that received A-beta oligomers exhibited significant memory retention impairment (P < 0·05) without apoptosis in the cornu ammonis (CA)1 and CA3 regions of the dorsal hippocampus. DISCUSSION: These data indicate that septal injection of A-beta impairs memory retention, even in the absence of hippocampal apoptosis. This result might bring new insight to spatial memory-related disorders like Alzheimer's disease (AD).

In this study, we aimed to investigate habituation of pattern-reversal visually evoked potentials (VEPs) in patients with relapsing remitting (RR) multiple sclerosis (MS). Twenty-one patients with this diagnosis and with a history of optic neuritis (ON), 29 such patients without a history of ON, and 25 normal controls were enrolled to study. One eye of each patient in the group with a history of ON and one eye of each subject in the control group was randomly selected. In the group with a past history of ON, the affected eye of the patients was selected in unilateral cases and the eye in which showed the greater latency delay of the P100 component in bilateral cases. P100 amplitudes were determined by visual inspection in 10 blocks of 512 responses and habituation was analysed as the percentage amplitude change between the 1st and 2nd-10th blocks. Amplitude of the P100 component of the VEP showed a significant clear-cut habituation after the first block in the control group but neither patient group showed a significant decrease in P100 amplitude. We conclude that our electrophysiological study has shown a lack of habituation in patients suffering from RR MS. This result could be important for the evaluation of visual system involvement in patients with MS, with or without a previous history of ON.

ObjectivesThe aim of this study was to develop a Turkish version of the painDETECT questionnaire (PD-Q) and assess its reliability and validity. MethodsTwo hundred and forty patients who were diagnosed by expert pain physicians in daily clinical practice and classified as having either neuropathic, nociceptive, or mixed pain for at least 3 months were enrolled in this study. After the usual translation process, the Turkish version of the PD-Q was administered to each participant twice with an interval of 48 hours. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), Douleur Neuropathique en 4 questions (DN4) and a pain visual analog scale were assessed along with the PD-Q. Chronbach's was calculated to evaluate internal consistency of the PD-Q. Intraclass correlation coefficient was calculated to examine test-retest reliability. Convergent validity was assessed by correlating the scale with LANSS and DN4. Discriminant statisticssensitivity, specificity, Youden index, positive predictive value, negative predictive valuewere also assessed. ResultsA total of 240 patients with chronic pain, 80 patients in each neuropathic, nociceptive, and mixed pain group, were included in this study. Mean age of the patients was 54.1 years, and majority of the patients were female (52.9%). Chronbach's of the Turkish version of the PD-Q was 0.81. The test-retest reliability of the Turkish version of the PD-Q was determined as 0.98 for the total score and ranged from 0.86 to 0.99 for individual items. The Turkish version of the PD-Q was possitively and significantly corralated with LANSS (r 0.89, P

The signs and symptoms of acute disseminated encephalomyelitis are heterogeneous and dependent on the location and severity of the inflammatory process. The meningoencephalitic presentation may include meningism, impaired consciousness (occasionally leading to coma), seizures and confusion, or behavioral disturbances. Multifocal neurological features include a combination of optic neuritis, visual field defects, cranial neuropathy, sensorimotor impairment, ataxia, aphasia, and involuntary movements. One definition of acute disseminated encephalomyelitis is "an initial clinical event with a presumed inflammatory and demyelinating cause, with acute or sub-acute onset affecting multifocal areas of the central nervous system". Patients with acute disseminated encephalomyelitis frequently suffer from seizures, disturbances of consciousness, fever, and headaches, and occasionally there are focal signs and symptoms. Here, we report on two cases who presented with different symptoms, but the clinical findings that the patients showed were benign.

This study investigates the correlation between brain magnetic resonance imaging findings and blink reflex abnormalities in patients with relapsing remitting multiple sclerosis. Twenty-six patients and 17 healthy subjects were included in this study. Blink reflex test (BRT) results were obtained using right and left stimulations; thus, 52 BRT results were recorded for the patient group, and 34 BRT results were recorded for the control group. The magnetic resonance imaging (MRI) findings were classified based on the existence of brainstem lesions (hyperintense lesion on T2 weighted (W) and fast fluid-attenuated inversion recovery MRI or contrast-enhancing lesion on T1W MRI). Correlation analysis was performed for the BRT and MRI findings. The percentage of individuals with abnormal BRT results (including R1 latency, ipsilateral R2 latency, and contralateral R2 latency) was significantly higher in the patient group as compared to the control group (p values: 0.015, 0.001, and 0.002, respectively). Correlation analysis revealed significant correlations between contralateral R2 latency abnormalities and brainstem lesions (p value: 0.011). Our results showed significant correlation correlations between contralateral R2 latency abnormalities and brainstem lesions and these results may be explained the effects of multiple demyelinating lesions of the brain stem of patients with relapsing remitting multiple sclerosis.

OBJECTIVES: The aim of this study was to develop a Turkish version of the painDETECT questionnaire (PD-Q) and assess its reliability and validity. METHODS: Two hundred and forty patients who were diagnosed by expert pain physicians in daily clinical practice and classified as having either neuropathic, nociceptive, or mixed pain for at least 3 months were enrolled in this study. After the usual translation process, the Turkish version of the PD-Q was administered to each participant twice with an interval of 48 hours. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), Douleur Neuropathique en 4 questions (DN4) and a pain visual analog scale were assessed along with the PD-Q. Chronbach's α was calculated to evaluate internal consistency of the PD-Q. Intraclass correlation coefficient was calculated to examine test-retest reliability. Convergent validity was assessed by correlating the scale with LANSS and DN4. Discriminant statistics-sensitivity, specificity, Youden index, positive predictive value, negative predictive value-were also assessed. RESULTS: A total of 240 patients with chronic pain, 80 patients in each neuropathic, nociceptive, and mixed pain group, were included in this study. Mean age of the patients was 54.1 years, and majority of the patients were female (52.9%). Chronbach's α of the Turkish version of the PD-Q was 0.81. The test-retest reliability of the Turkish version of the PD-Q was determined as 0.98 for the total score and ranged from 0.86 to 0.99 for individual items. The Turkish version of the PD-Q was possitively and significantly corralated with LANSS (r 0.89, P < 0.001) and DN4 (r 0.82, P < 0.001). When the two cutoff values in the original version were used, sensitivity was found 77.5% for a cutoff value ≤19, and specificity was 82.5%. Sensitivity and specificity were 90% and 67.5%, respectively, for the other cutoff value ≤12. Scores ≤12 represents a negative predictive value = 87%, and scores 19≤ represents a positive predictive value = 82%. When mixed pain patients were included in the neuropathic pain group, discriminant values were reduced as expected. CONCLUSIONS: The Turkish version of the PD-Q is a reliable and valid scale to be used to determine neuropathic component of chronic pain in Turkish patients.