Performing the screw fixation from C3 to odontoid process in a patient with Klippel-Feil syndrome and type II odontoid fracture

A 56-year-old female patient was admitted with a history of pain during neck movements after cervical injury. Computerized tomography scan revealed type II odontoid fracture and fusion anomaly between C2 and C3 vertebrae. At surgery, the anteroinferior part of C2 vertebra corpus could not be reached; therefore, transodontoid screw was advanced from C3 vertebra toward odontoid process. At follow-up examination, the complaints of the patient had recovered, and fracture line was completely fused. Advancing screw from C3 to odontoid process via anterior cervical approach could be thought an alternative treatment option in the patient with short neck caused from vertebra fusion anomaly and/or obesity

BILATERAL SUBDURAL HEMATOMA AFTER VENTRICULOPERITONEAL SHUNT SURGERY

WOS: 000500774900009Background: Bilateral subdural hematoma (SDH) following ventriculoperitoneal (V/P) shunt application was discussed in present case. Case Report: 8-year-old girl was operated due to thoracolumbar meningomyelocele immediately after birth. V/P shunt was inserted in right posterior parietal region due to hydrocephalus when she was 3 month-old. At age of 3 years, V/P shunt dysfunction was considered, and second V/P shunt was inserted in left posterior parietal region. One year after, patient was reevaluated, and CT images showed bilateral subacute SDH. Hematoma evacuation was not considered, but right ventricular catheter was ligated. At four years follow-up, no additional neurological impairment was observed in patient and CT scan revealed that SDHs were retracted greatly. Concusion: It should be kept in mind that SDH could develop after V/P shunt surgery. Additionally, it could be said that one of most important factor in determination of treatment of this complication was primarily neurological examination findings of patient

Biochemical markers in the prognosis of intracranial hemorrhages

KISA, Ucler/0000-0002-8131-6810WOS: 000437950000012Purpose: The aim of this study was to determine prognosis of patients with intracranial hemorrhage by examining routine laboratory findings. Materials and Methods: Patients were divided into three groups according to hemorrhage type (subarachnoid hemorrhage, spontaneous intracerebral hematoma, subdural hematoma). Then serum sodium, potassium, C-reactive protein, blood leukocyte count and neutrophil percentage values were measured pre- and postoperatively. Results: Twenty-eight patients (10 female, 18 male) were included in study. There was no difference among groups in terms of all parameters. However, postoperative leukocyte counts were higher than preoperative values in intracerebral hematoma group; and postoperative sodium levels were higher than preoperative values in subarachnoid hemorrhage group. There was found negative correlation between Glasgow Outcome Scale scores and preoperative neutrophil, preoperative and postoperative sodium values in subarachnoid hemorrhage group. A negative correlation was found between Glasgow Outcome Scale scores and preoperative C-reactive protein values in subdural hematoma group. Conclusion: Study results suggested that pre-and postoperative serum sodium values in subarachnoid hemorrhage; age, Glasgow Coma Scale score, pre-and post-operative C-reactive protein values in spontaneous intracerebral hematoma; and preoperative C-reactive protein values in subdural hematoma were considered to be predictors of patient prognosis

Cerebral ischaemia/reperfusion injury could be managed by using tramadol

KISA, Ucler/0000-0002-8131-6810; DINCEL, Gungor Cagdas/0000-0002-6985-3197; BAKAR, BULENT/0000-0002-6236-7647WOS: 000445794000009PubMed: 29792388Objectives: No valid treatment modality that will repair stroke damage and provide neurological recovery has yet been identified in literature. Studies demonstrated that adequate quality of life could be provided if post-stroke pain could be treated sufficiently and timely. Besides its pain relief effects, tramadol has oedema-reducing and anti-inflammatory properties. With these in mind, this study investigated the influence of tramadol in acute and/or chronic ischaemia/reperfusion (I/R) injury. Methods: Putting aside the Control group, 23 Wistar albino rats were distributed to four groups to investigate the acute (Sham-A, TR-A) and chronic (Sham-C, TR-C) periods of I/R injury, and temporary aneurysm clips were applied to their internal carotid arteries for 30 min. Four hours after clippage, tramadol was administered to animals of TR-A and TR-C groups intraperitoneally. After sacrificing all animals, pyknotic and necrotic neuronal cells in hippocampal cornu ammonis (CA)1, CA2, CA3 and parietal cortical regions were counted, and perivascular oedema, intercellular organization disorder (IOD) and inflammatory cell infiltration were scaled histopathologically. Additionally, tissue interleukin (IL)-1 beta, IL-10, malondialdehyde, nitric oxide, tumour necrosis factor-alpha, caspase-3, beclin-1, Atg12, LC3II/LC3I levels were measured biochemically. Results: Tramadol could minimize perivascular oedema, IOD, parietal and hippocampal neuronal necrosis, inflammatory cell infiltration in both periods of I/R injury histopathologically. Apart from inhibiting apoptosis and enhancing autophagy, tramadol had no influence on any other biochemical result. Discussion: Tramadol can ameliorate the histopathological structure of ischaemic tissue in both periods of I/R injury in rat. We suggest further research investigating various dosages with different administration methods of tramadol in stroke should be conducted by adopting different explorative techniques

Picturing asthma in Turkey: results from the Turkish adult asthma registry

Introduction: National data on asthma characteristics and the factors associated with uncontrolled asthma seem to be necessary for every country. For this purpose, we developed the Turkish Adult Asthma Registry for patients with asthma aiming to take a snapshot of our patients, thereby assigning the unmet needs and niche areas of intervention. Methods: Case entries were performed between March 2018 and March 2022. A web-based application was used to record data. Study outcomes were demographic features, disease characteristics, asthma control levels, and phenotypes. Results: The registry included 2053 patients from 36 study centers in Turkey. Female subjects dominated the group (n = 1535, 74.8%). The majority of the patients had allergic (n = 1158, 65.3%) and eosinophilic (n = 1174, 57.2%) asthma. Six hundred nineteen (32.2%) of the patients had obese asthma. Severe asthma existed in 670 (32.6%) patients. Majority of cases were on step 3–5 treatment (n: 1525; 88.1%). Uncontrolled asthma was associated with low educational level, severe asthma attacks in the last year, low FEV1, existence of chronic rhinosinusitis and living in particular regions. Conclusion: The picture of this registry showed a dominancy of middle-aged obese women with moderate-to-severe asthma. We also determined particular strategic targets such as low educational level, severe asthma attacks, low FEV1, and chronic rhinosinusitis to decrease uncontrolled asthma in our country. Moreover, some regional strategies may also be needed as uncontrolled asthma is higher in certain regions. We believe that these data will guide authorities to reestablish national asthma programs to improve asthma service delivery