Evaluation of accuracy, reliability, quality, and readability of online patient information materials on coccyx injury

MakaleWOS:000928222100009PubMed ID: 36701705The aim of this research is to evaluate the websites containing “coccydynia, coccyx trauma or fracture” in terms of readability, reliability, accuracy, and quality. Searches for “coccydynia, coccyx trauma, coccyx fracture” were carried out in the 3 most used search engines in the USA: Google, Yahoo, and Bing in February 2022. A total of 141 websites were rated by 2 different neurosurgeons for the “Global Quality Score” and “Alexa Popularity Rank.” 97.2% of the sites examined include the definition of the disease, 66% include the importance of the disease, 92.9% include the symptoms of the disease, 88.7% include the treatment of the disease, 78% include the signs of the disease, 77.3% include the mechanism of the disease It has been determined that the websites examined within the scope of the research have high global quality score (GQS) and APR and are enriched with images to a large extent. Abbreviations: APR = Alexa popularity rank, ARI = automated readability index, CLI = Coleman-Liau Index, FKGL = FleschKincaid Grade Level, FRES = Flesch reading ease, GQS = global quality score, Gunning FOG = Gunning Fog Index, LWF = Linsear Write Formula, SMOG = simple measure of gobbledygoo

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

Experimental subearnoididation of tocilizumabeffects on cerebral vazospazm

IL-6 inhibitörü olan tocilizumab hem romatoid artrit hem de Behçet hastalığı gibi otoimmün rahatsızlıklarda anti-inflamatuvar etkili bir ilaç olarak kullanılmıştır. Bunun yanında patofizyolojisinde inflamasyonun da yer aldığı serebral iskemide de aynı şekilde kullanılmıştır.Ancak SAK sonrası gelişen vazospazm da etkisi bilinmemektedir. Bu çalışmanın amacı tocilizumabın SAK sonrası gelişen vazospazm üzerine etkilerini biyokimyasal, histopatolojik ve fonksiyonel etkilerini olarak incelemektir. Yöntem:Bu çalışmada 48 adet erişkin 300-350 gr ağırlığında erkek Wistar albino rat kullanılmıştır. Ratlar 4 gruba ayrılmıştır: grup 1 (kontrol), grup 2(SAK), grup 3(SAK+salin), grup 4(SAK+tocilizumab). Tocilizumab tedavisi (8mg/kg/gün ip) olarak verilmiş ve tedaviye SAK oluşturulduktan sonra başlanarak tedavi 72 saat sürdürülmüştür. Ratlar sakrifiye edildikten sonra ratların beyin dokularında bcl-2(bax), caspase-3, STAT-3, IL-6, IL-1, TNF- ve VEGF düzeyleri ve beyin sapından elde edilen baziller arter kesitlerinde Hemotoksilen-Eozin ve Tunel yöntemleri ile nöronal hasar, baziller arter çapı ve apopitozis skoru hesaplanacaktır Çalışma sonrası elde edilen değerler SPSS 21.0 (Windows için SPSS, version 21.0; SPSS, Chicago, ABD) programı ile değerlendirilmiştir.Verilerin gruplar arası karşılaştırılmasında Kruskal Wallis varyans analizi kullanıldı. Gruplar arası veri farkları bulunduğunda gruplararası hangi verilerin farklı olduğunu belirlemek için Mann Whitney U kullanıldı. İstatistiksel olarak p<0.05 anlamlı olarak kabul edildi. Sonuçlar tablo ve grafiklerle gösterildi. Bulgular:Yaptığımız histolojik çalışmada apopitozis varlığını gösteren TUNEL pozitif endotel hücre yüzde ortalamalarının SAK ve SAK+Salin grubunda kontrol grubuna göre istatistiksel olarak anlamlı arttığı belirlendi. Toc'un ise TUNEL pozitif endotel hücre yüzde ortalamasını istatistiksel olarak anlamlı düşürdüğü belirlendi.Çalışmamızda, SAK sonrasında baziller arter duvar kalınlığında artış ve lümen alanı ortalama ölçüm değerlerinde ise azalma meydana gelmiştir. İnflamatuar Sitokinler olan IL6, TNF- ve IL-1 seviyesinde SAK ve SAK+salin grubuna göre anlamlı oranda azalma, propopitotik bax ve caspaz seviyesinde SAK ve SAK+salin grubuna göre anlamlı azalma, anjiogenez molekulü olan VEGF'de SAK ve SAK+Salin grubuna göre anlamlı zalma tespit ettik. Sonuç: Tocilizumab tedavisininin etkilerini araştırdığımız deneysel çalışmamızda SAK sonrası artan endotel apopitozisini ve arter duvar kalınlığını azalttığı, lümen alanında meydana gelen daralmayı engellediği, nöroprotektif etkide artış sağladığı ve inflamasyonda azalma sağladığı gösterilmiştir. Anahtar Kelimeler: Subaraknoid Kanama, Vazospazm, Tocilizumab, RatTocilizumab, which is an IL-6 inhibitor, has been used as a medication with antiinflammatory effects in autoimmune diseases like rheumatoid arthritis and Behcet's disease. In addition, it has been used in the same way in cerebral ischemia whose pathology includes inflammation. However, its effects are not known in vasospasm that develops after SAH. METHODS:In this study, 48 adult male Wistar albino rats weighing 300-350 grams were used.Rats were divided into 4 groups: group 1 (control), group 2 (SAH), group 3 (SAH + saline), group 4 (SAH + tocilizumab).Tocilizumab treatment was given at a dose of 8mg / kg / day and treatment was continued for 72 hours after the SAH was established.After the rats are sacrificed, bcl-2(bax), caspase-3, STAT-3, IL-6, IL-1, TNF- and VEGF levels in the brain tissues of ratsand neuronal damage, basilar artery diameter, and apoptosis score will be calculated by Hemotoxylin-Eosin and Tunel methods in basilar artery sections obtained from brain stem. Values obtained after the study were evaluated by SPSS 21.0 (SPSS for Windows, version 21.0; SPSS, Chicago, USA) program.Kruskal Wallis analysis of variance was used for comparison of data between groups. Mann Whitney U test were used to determine which data differ between groups when data differences between groups were found.Statistically, p <0.05 was considered significant. The results are shown in tables and graphs. RESULTS: In our histological study, it was determined that the percentages of TUNEL positive endothelial cells that reveal the existence of apoptosis increased statistically significantly in the SAH and SAH + Saline group compared to the control group.Tocilizumab decreased the mean percentage of TUNEL positive endothelial cells in a statistically significant manner.In our study, basilar artery wall thickness was increased and mean luminal area was decreased after SAH. In our study we found significant reduction in levels of inflammatory cytokines (IL6, TNF- and IL-1) compared to SAK and SAK + Saline group. Propitotic bax and caspase levels were significantly lower than the SAK and SAK + saline groups and alsothere is a significant decrease in the angiogenesis molecule VEGF compared to the SAK and SAK + Saline group. CONCLUSION:In our experimental study investigating the effects of Tocilizumab treatment, it has been shown that tocilizumab reduces the endothelial apoptosis and increased arterial wall thickening after SAK, prevents narrowing in the lumen area, increases neuroprotective effect and decreases inflammation. Keywords: Subarachnoid Hemorrhage, Vasospasm, Tocilizumab, Rat

Meme Kanserli Hastada İzole Dural-Kalvaryal Metastaz: Olgu Sunumu

Literatürde malign neoplazmların dural metastazları ile ilgili az bilgi bulunmaktadır. Kesin etyopatogenezleri ve tedavi stratejileri tartışmalıdır. Dura matere en sık metastaz meme kanserinden olmaktadır. 41 yaşında bayan hasta kliniğimize baş ağrısı ve sol parietalde şişlik şikayeti ile başvurdu. Hasta 3 yıl önce infiltratif duktal kanser nedeni ile opere edilmişti. Sol kalvaryal ve dura metastazı tespit edildi ve sol pariyetal kraniotomi ile cerrahi rezeksiyon uygulandı. Hasta operasyondan sonra tüm beyin radyoterapi aldı. Bu yazıda kafatası ve duraya metastaz yapan bir kanser vakasını ve bu nadir hastalığın ana özelliklerini tartıştık.There is little information about the dural metastasis of malign neoplasms in the literature. The exact etiopathogenesis and treatment strategies are controversial. The most common site for breast cancer metastasis is dura matter. Forty one years old female patient admitted to our clinic with headache and left parietal swelling complaints. The patient was operated due to infiltrative ductal cancer three years ago. A left parietal calvarial and dural metastasis determined and surgically resected via left parietal craniotomy. The patient underwent whole brain radiotherapy after this operation. In this report we present an unusual case of cancer metastasis to the skull and dura and discuss the main features of this disease