Improved spinal MRI findings after epidural blood patch administration: A pediatric case

Orthostatic headache is the leading clinical manifestation of CSF leakage. Anatomic changes due to low CSF pressure can be detected by cranial and spinal magnetic resonance imaging (MRI). We report improved spinal MRI findings in a pediatric case of post-dural puncture headache treated by epidural blood patch administration.In this case, a 7-year-old girl with a history of recurrent lumbar punctures and orthostatic headache for three months is presented. Cerebrospinal fluid (CSF) leak was reported at the level of T5-L1 by magnetic resonance imaging (MRI). An autologous epidural blood patch was performed under sedation with a blood volume of 6 ml. Five days after the procedure MRI showed no CSF signal in the extradural space and dural infolding was found to be disappeared. On the seventh day of the procedure, headache recurred and the procedure was repeated using same amount of blood. After seven months of follow-up, the patient reported no recurrence of headache.To the best of our knowledge, this is the first pediatric case report that presents improved spinal MRI findings following an epidural blood patch. Although MR findings show improvement, it is not a definitive proof of the adequacy of the treatment. Keywords: Pediatric patient, Epidural blood patch, Post-dural headache, Spinal MRI, Intracranial hypotension, Injection resistanc

Investigation of obesity-related HAdV-36 in NAFLD patients: A case-control study

Background: HAdV-36 leads to adipocyte proliferation of adipose tissue through E4orf1 gene, leading to the development of obesity and related diseases. We aimed to investigate the presence and any association of HAdV-36 in non-alcoholic fatty liver disease (NAFLD) patients Methods: The patient group was composed of 116 patients; 30 obese patients with NAFLD (BMI > 30 kg/m2), 30 patients with Diabetes Mellitus (DM)+NAFLD (BMI > 30 kg/m2), 16 patients with NAFLD (BMI 30 kg/m2). The control group comprised 81 non-obese healthy adults. Liver adipose tissue samples were obtained in 30 operated NAFLD patients. HAdV-36-DNA, HAdV-36 neutralizing antibodies, serum lipid, and adipokine levels were analyzed. Results: HAdV-36 neutralizing antibodies (HAdV-36 Ab-positive) were detected in 10/116 and 2/81 participants in the study and control groups, respectively; the difference was statistically significant (p < 0.005). LDL, total cholesterol but not adipokine levels were found to be significantly higher in HadV-36 Ab-positive patients (p < 0.05). While HAdV-36 was identified as a risk factor with OR = 4.11 in univariate analyses, there was no significant difference in binary logistic regression analysis. HAdV-36-DNA was detected in the adipose tissue samples of two patients. Conclusions: We suggest that the presence of HAdV-36 may lead to the development of obesity with the increase in adipose tissue, and diseases such as hyperlipidemia, NAFLD, DM, and metabolic syndrome may develop on the basis of chronic inflammation caused by obesity. Thus, HAdV-36 may be a plausible risk factor for the development of NAFLD.Istanbul University-Cerrahpaşa Scientific Research Projects Uni

Franchismo

We aimed to obtain information about the characteristics of the ICUs in our country via a point prevalence study