Efficacy of c-arm scopy-guided erector spinae plane block (ESPB) in postoperative pain control and reduction of opioid side effects in spinal instrumentation surgery

Background: Spinal instrumentation surgery causes significant pain in patients. As a result, patients are exposed to excessive opioid use and the associated side effects, as well as prolonged hospital stay, resulting in economic burden. Local anaesthetics can help both reduce postoperative pain and minimize the side effects associated with systemically administered opioid analgesics. Objective: The aim of this retrospective study was to investigate the effect of erector spinae plane block on analgesia in spinal instrumentation surgery and to reduce the side effects of excessive opioid use. Materials and Methods: We reported a retrospective study. Thirty patients, who underwent spinal instrumentation surgery from 2017 to 2018, were chosen from the hospital records. We performed spinal instrumentation and decompression by laminectomy to all patients under general anaesthesia. While 15 of these patients underwent erector spinae plane block, these patients received patient-controlled analgesia postoperative period. The other 15 patients received only patient-controlled analgesia postoperative period. We analyzed patients' data for differences in preoperative and postoperative visual analogue scores, nausea vomiting scores, constipation life quality scale, patient-controlled analgesia shot count and mean opioid consumption of patients. Results: The data of 30 patients undergoing lumbar spinal instrumentation surgery were retrospectively analyzed. There was no significant difference in the age, preoperative VAS, preoperative ODI and sex between the two groups (p?0,05). In addition, there were statistically significant differences in postoperative VAS, postoperative ODI, Nausea Vomiting Score, Constipation Life Quality Score (CLQS), petidin consumption and PCA shot count (p <0.05). In all variables with significant differences, the values ??in the block group were lower than the non-block group. Conclusion: ESPB provides effective analgesia and reduces side effects due to excessive opioid usage

Association of platelet count and platelet indices with cranial meningioma

Introduction and Objectives: In this study, we aimed to investigate whether platelet count (PLT) and platelet indices included mean platelet volume (MPV), platecrit (PCT), platelet distribution width  (PDW) values can be used as diagnostic markers in cranial meningiomas. Materials and Methods: The study included results of 29 patient and 47 healthy contributors. Based on pathologies, the patients were divided into two groups. The first group included meningioma patients and the second one included healthy individuals. Healthy contributors named control group. Platelet count and platelet indices were determined using Sysmex XN 550 haematology analyzer. The preoperative platelet count (PLT) and platelet indices included mean platelet volume (MPV), platecrit (PCT), platelet distribution width  (PDW) values were recorded from the routine laboratory tests. Results: There was no statistically significant difference in PLT between the meningioma and healthy groups (p = 0.217). There was a statistically significant difference in PCT between the meningioma group and the healthy group (p = 0.002). There was a statistically significant difference in PDW between meningioma group and healthy group (p = 0.001). In terms of MPV, there was a statistically significant difference between meningioma group and the healthy group (p = 0.001) Conclusion: Platelet count and indices are easily available in the routine blood tests. Despite the retrospective design and small sample size, our findings suggest that altered MPV, PDW and PCT levels might serve as potential biomarkers for the diagnosis of meningiomas

Computed tomography-based morphometric measurements of the atlas (C1) posterior arc

Study design: Single-center retrospective study Objectives: This study is performed to determine the anatomic feasibility of the C1 posterior arc screw and help select an optimal screw trajectory in treating patients with craniovertebral junction pathologies. Material and Methods: We reported a single-centre retrospective study. Forty patients (20 male and 20 female) who underwent cervical computed tomography (CT) were chosen from the hospital records. Based on CT images, we measured left laminar length (LLL), right laminar length (RLL), left laminar angle (LLA), right laminar angle (RLA), left laminar axial thickness (LLAT), right laminar axial thickness (RLAT), left laminar coronal thickness (LLCT), right laminar coronal thickness (RLCT), and craniocaudal angle (CCA) of the C1 posterior arc. Results: The mean values and standard deviations (SD) for nine parameters at the C1 posterior arc were determined. LLL, RLL, LLCT, and RLCT were statistically longer in men than women. RLAT was bigger in men but there was no statistical difference. RLA was statistically wider in women than men. LLA and CCA were wider in women but there was no statistical difference, LLAT was bigger in women but there was no statistical difference. There was no statistical difference in measurements by age. Conclusion:  The results of this study are important to avoid neurovascular injury and pedicle breakage because of choosing large screw while performing C1 laminar screw fixation

The efficacy of adalimumab on experimentally induced spinal cord ischemia-reperfusion injury

Objective: Paraplegia is a dangerous complication of thoracoabdominal aortic surgery. Various studies have been conducted on the prevention of this complication and some spinal cord protection methods have been proposed. However, there is not any modality that prevent the development of paraplegia certainly. In the I / R period, primary injury triggers secondary injury due to increased inflammation, apoptosis and free radical formation. In this study, we evaluated that the neuroprotective effect of adalimumab in spinal cord ischemia-reperfusion injury.  Materials and Methods: In total, 24 adult New Zealand rabbits were divided into three groups: Group 1, control; Group 2, ischemia-reperfusion by infrarenal aortic clamping; Group 3, adalimumab treated followed by ischemia. Tissue and plasma tumor necrosis factor alpha, interleukin 6, interleukin 10, thiobarbituric acid reactive substance, total oxidant status and total antioxidant status levels were analyzed as a marker of inflammation and oxidation. Histopathological evaluation of the tissues was performed, and apoptosis was evaluated by TUNNEL method. Results: I/R injury significantly increases plasma and spinal cord tissue at TNF alpha, TOS, TBARS, IL6 levels and reduces plasma and spinal cord tissue to TAS and IL10 levels. Adalimumab treatment significantly reduces plasma and spinal cord tissue to TNF alpha, TOS, TBARS, IL6 and increases plasma and tissue to TAS and IL10 levels. Conclusion: Adalimumab treatment significantly reduces the spinal cord neuronal damage score and the number of apoptotic cells. This paper aims to demonstrate the important neuroprotective effects of adalimumab on rabbit spinal cord I/R injury

Poor prognosis in paediatric haemorrhagic stroke

MakaleWOS:000936965000001PubMed ID: 36661106Stroke, increasingly recognised in children in recent years, is an important cause of long-term morbidity and disability. A wide range of conditions associated with paediatric stroke has been identified, which differ significantly from those in adults. Paediatric stroke can also present with a variety of symptoms and signs, both specific and non-specific [1, 2]. Paediatric haemorrhagic stroke (HS) is a rare but severe condition, with lifelong multifaceted adverse functional, psychosocial, and economic consequences [3]. In this study, we have evaluated the clinical, laboratory and neuroimaging findings in children with HS in order to draw attention to the high morbidity and mortality rates of paediatric HS. (...

A study on mushroom management perception of employees in Provincial Directorates of Youth and Sports (Niğde province example): Gençlik ve Spor İl Müdürlüklerinde çalışanların mantar yönetim algısı üzerine bir çalışma (Niğde ili örneği)

It seems that the mushroom management metaphor has become a new research area in management sciences. This management style takes its name from mushroom cultivation in terms of method similarity. In mushroom cultivation; mushrooms are left in the dark and only allowed to grow by giving them the resources they need. In the mushroom management metaphor, managers leave employees in a kind of darkness. They provide only the resources they need without conducting mutual communication with them and does not need to share information with the employees. At the end of this process, managers expect an increase in performance from their employees. Within the scope of this study, it was aimed to measure the mushroom management perceptions of 4-a and 4-b employees in Niğde Provincial Directorate of Youth and Sports. The sample of the study consists of 92 civil servants, 42 women and 50 men, working in the Niğde Provincial Directorate of Youth and Sports. Personal information form and the “Mushroom Management Scale” developed by Birioğlu and Tekin (2018) were used as data collection tools. Descriptive statistics were used in the analysis of the data, T-test was used for pairwise comparisons, and ANOVA test was used for more than two comparisons. As a result, according to the findings, it was determined that the employees had a medium level of mushroom management perception. No significant difference was found between the sub-dimensions of administrative duty, gender, age, and tenure. ​Extended English summary is in the end of Full Text PDF (TURKISH) file.   Özet Mantar yönetim metaforunun, yönetim bilimlerinde yeni bir araştırma alanı haline geldiği görülmektedir. Bu yönetim tarzı ismini metot benzerliği açısından mantar yetiştiriciliğinden almaktadır. Mantar yetiştiriciliğinde; mantarlar karanlıkta bırakılır ve sadece ihtiyacı olan kaynaklar verilerek yetişmesi sağlanır. Mantar yönetim metaforunda da yöneticiler, çalışanları bir çeşit karanlıkta bırakır; onlarla karşılıklı iletişim yürütmeden sadece onların ihtiyacı olan kaynakları sağlar ve çalışanlarla bilgi paylaşımına gerek duymaz. Bu sürecin sonunda yöneticiler, çalışanlardan performans artışı beklerler. Bu çalışma kapsamında, Niğde Gençlik ve Spor il Müdürlüğünde 4-a ve 4-b çalışan personellerin mantar yönetim algılarının ölçülmesi amaçlamıştır. Çalışmanın örneklemini, Niğde Gençlik ve Spor İl Müdürlüğünde çalışan, 42 kadın, 50 erkek olmak üzere toplam 92 memur oluşturmaktadır. Veri toplama aracı olarak kişisel bilgi formu ve Birincioğlu ve Tekin (2018) tarafından geliştirilen “Mantar Yönetim Ölçeği” kullanılmıştır. Verilerin analizinde tanımlayıcı istatistikler, ikili karşılaştırmalarda T-testi, ikiden fazla karşılaştırmalarda Anova testi uygulanmıştır. Sonuç olarak; elde edilen bulgulara göre çalışanların orta düzeyde mantar yönetim algısına sahip oldukları belirlenmiştir. İdari görev, cinsiyet, yaş ve görev süresi ile alt boyutlar arasında hiçbir anlamlı farklılık tespit edilememiştir

The effects of alpha lipoic acid on lipid peroxidation, antioxidant status and endothelial apoptosis in experimental subarachnoid hemorrhage and vasospasm

Bu çalışma ile ALA'nın tavşanlarda oluşturulan subaraknoid kanama modelinde vazospazm üzerine etkileri incelenmiştir.Gereç ve Yöntem: Yirmibir adet erkek, Yeni-Zelanda tipi tavşan randomize olarak her biri 7 tavşandan oluşan 3 gruba ayrılmıştır: grup 1 (kontrol), grup 2 (SAK), grup 3 (SAK+ALA). ALA tedavisi (100mg/kg/gün ip) olarak verilmiş ve tedaviye SAK oluşturulmadan hemen önce başlanarak tedavi 72 saat sürdürülmüştür. Yetmiş iki saatin sonunda denekler sakrifiye edilerek elde edilen beyin sapı dokularında doku MDA, SOD, GSH-Px düzeyleri ölçülmüş ayrıca elde edilen baziller arter kesitlerinde arter duvar kalınlığı, arter lümen alanı ve immünohistokimyasal olarak da endotelial apopitoz yüzdeleri tespit edilmiştir.Bulgular: Tavşanlarda oluşturulan vazospazm modelinde ALA tedavisi istatistiksel olarak anlamlı şekilde vazospazm gelişimini engellemiştir. SAK sonrasında artış gösteren MDA düzeyleri tedavi ile azalmış, SOD ve GSH-Px'de görülen azalma ise engellenmiştir. Histopatolojik olarak ALA, SAK sonrası ortaya çıkan arter duvar kalınlaşmasını ve arter lümen alanındaki daralmayı engellemiştir. İmmunohistokimyasal olarak ALA, SAK sonrasında görülen endotelial apopitozu azaltmaktadır.Sonuç: ALA tavşanlarda oluşturulan SAK modelinde vazospazm gelişimini engellemektedir. ALA'nın SAK sonrasında nöroprotektif ve apopitozu düzenleyici etkileri olduğu bu çalışma ile gösterilmiştir. ALA, SAK sonrası görülen serebral vazospazmda potansiyel bir tedavi edici ve engelleyici ajan olarak karşımıza çıkmaktadır. Klinik uygulamaya geçilebilmesine yönelik daha ileri çalışmalara ihtiyaç vardır.This study investigated the ability of ALA to prevent cerebral vasospasm in a rabbit model of SAH.Material-Methods: Twenty-one, male New Zealand white rabbits were randomly divided into 3 groups of 7 rabbits each: group 1 (control), group 2 (SAH only), group 3 (SAH + ALA treatment). ALA (100 mg/kg, single dose, IP) was administered just before SAH and continued until 72 hours after SAH in group 3.Animals were killed 72 hours after SAH. Tissue MDA levels, SOD, and GSH-Px activities were measured, and basilar artery cross-sectional areas, arterial wall thickness, and endothelial apoptosis in a cross section of basillary artery were determined.Results: ALA treatment was found to be effective against developing a cerebral vasospasm following a SAH in rabbits. It could significantly reduce elevated MDA levels and increase the level of tissue GSH-Px and SOD enzymatic activities. ALA treatment was found to be effective in increasing the luminal area and reducing wall thickness of the basilar artery. ALA markedly reduced apoptotic index and protects the endothelial integrity.Conclusion: ALA treatment might be beneficial in preventing cerebral vasospasm after SAH, thus showing potential for clinical implications. Further studies needed to decide acceptability of ALA for clinic utilization

Endoscopic endonasal transsphenoidal surgery for pituitary adenomas

Endoscopic endonasal transsphenoidal surgery (EETS) is a widely accepted technique for the surgical resection of pituitary tumours. In this report, we present our single-centre experience with EETS for pituitary adenomas, mainly focusing on its efficacy and postoperative complications. Among 100 patients who underwent EETS, 57 (57%) were female and 43 were (43%) male. The mean age of the patients was 51.55 ± 13.51 years. Nonfunctional adenoma was found in 61 (61%) patients, acromegaly was found in 29 (29%) patients, Cushing’s disease in six (6%), and prolactinoma was found in four (4%) patients. On average, a 75.8% decrease in the postoperative tumour volume was observed in nonfunctional adenomas. Surgical cure was achieved in 51.7% of patients with acromegaly, 50% of those with Cushing’s disease, and 25% of those with prolactinoma.  The most common postoperative complication was found to be cerebrospinal fluid fistula

Endoscopic endonasal transsphenoidal surgery for pituitary adenomas: A single-centre initial experience

Endoscopic endonasal transsphenoidal surgery (EETS) is a widely accepted technique for the surgical resection of pituitary tumours. In this report, we present our single-centre experience with EETS for pituitary adenomas, mainly focusing on its efficacy and postoperative complications. Among 100 patients who underwent EETS, 57 (57%) were female and 43 were (43%) male. The mean age of the patients was 51.55 ± 13.51 years. Nonfunctional adenoma was found in 61 (61%) patients, acromegaly was found in 29 (29%) patients, Cushing’s disease in six (6%), and prolactinoma was found in four (4%) patients. On average, a 75.8% decrease in the postoperative tumour volume was observed in nonfunctional adenomas. Surgical cure was achieved in 51.7% of patients with acromegaly, 50% of those with Cushing’s disease, and 25% of those with prolactinoma.  The most common postoperative complication was found to be cerebrospinal fluid fistula