Epiduroscopy (Epidural Endoscopy)

Epiduroscopy is a relatively new technique used in the evaluation and treatment of low back pain via advancements in optical fiber technology. As a minimally invasive endoscopic technique, it allows for direct endoscopic imaging of the epidural space and helps the patients for the pain management who having post–lumbar surgery syndrome (PLSS) and other cases of low back pain and radiculopathy. An advanced understanding of the anatomy of epidural space and adjacent structures are also essential for positive and successful clinical outcomes. The use of epiduroscopy in the pain clinic is performed as a day procedure, and the patient is awake and can communicate with the doctor. During an epiduroscopy, thin tubes with a bright light and tiny fiberoptic camera at the end are inserted through the sacral hiatus into the epidural space around the dura and guided up toward the affected site. Anterior epiduroscopy and epiduroscopic laser neural decompression (ELND) have been recently introduced in treating herniated disc decompressions, and chronic low back pain and radicular pain, respectively. The most common complications of epiduroscopic approach are the pain in the intervention point, dural puncture, and headache

The Local Anesthetic and Pain Relief Activity of Alkaloids

Alkaloids have been known for several centuries and have been mainly obtained from natural sources that presented important properties with biochemical, pharmacological, and medical effects in living organisms. Alkaloids are derived from amino acids like other important molecules in the functioning of life in our body. Hence, alkaloids are considered as pharmacologically important. Alkaloids are secondary metabolites widely distributed in leaves, stem, root, and fruits of plants which synthesize them. However, administration and consumption of them at right doses are beneficial in terms of health; excess doses will be definitely poisonous and may cause even death. The pharmacological activities of alkaloids are quite diverse. They are important natural products with a wide range of medicinal properties including relief of pain (e.g., morphine), analgesic (e.g., codeine), antiarrhythmic (e.g., quinidine), antibacterial (e.g., chelerythrine), antiasthma (e.g., ephedrine), cholinomimetic (e.g., galantamine), and vasodilatory (e.g., vincamine)

Hemodynamic Monitoring Using A Pulse Counter Vigileo Flotrac Cardiac Output System In Transapical Off-Pump Minimally Invasive Mitral Valve Repair

The aim of this study was to present our anesthetic management and early hemodynamic recovery after transapical off-pump neochords implantation. Observational prospective study. The perioperative records of 13 patients who underwent mitral valve repair using the Neochord DS1000 system were analyzed. Hemodynamic measurements recorded with the Vigileo Flotrac invasive arterial cardiac output system were evaluated. Thirteen patients were included in the study. Transfusions of a total of 2 U of erythrocytes and 11 U of plasma were performed. After Neochord implantation, the mean cardiac output increased at a statistically significant level according to the values measured after induction p = 0.003. Increased cardiac output measurement after placement of the neochordaes and elimination of insufficiency have emerged as indications of early hemodynamic recover

Six-Month Results of Cervical Intradiscal Oxygen-Ozone Mixture Therapy on Patients with Neck Pain: Preliminary Findings

Conclusion: Based on our results, intradiscal injection of an O-2-O-3 mixture treatment showed 3 beneficial long-term effect

Managing Postpneumonic Empyema Thoracis in Children: Comparison of Different Treatment Options

Conclusions: Chest tube drainage can be said to be an efficient and safe primary treatment for PPE in children. In cases when chest tube drainage fails to satisfy, decortication with thoracotomy can be applied well with low mortality and morbidity rates

Long-term Clinical Effects of DiscoGel for Cervical Disc Herniation

Conclusions: RGE is a potential alternative to surgery for patients with pain at the cervical level. However, we concluded that more studies with longer follow-up intervals with RGE will be necessary for assessment of the technique's efficiency

Treatment Results of Patients Followed in Intensive Care Unit in Severe Maternal Morbidity Cases

Objective: The aim of this study was the evaluation of the characteristics and treatment results of women, who were brought to the intensive care unit due to severe obstetric morbidity, together with severe and acute complications in pregnancy. Study Design: Pregnant and puerperal women treated in the intensive care unit of a tertiary care center during two years of time were included in this study, and their files were scanned retrospectively. Patients’ demographic characteristics, length of stay, point of entry, neonatal results, birth statuses and modes of delivery, hemodynamic data, and histories were recorded. The qualitative data were evaluated by the Pearson Chi-squared, Fisher Freeman Halton, and Fisher’s Exact tests. Results: In the two-year period, 16,728 births occurred at our hospital. 68 cases among them were accompanied with severe maternal morbidity, and 2 maternal deaths were observed in our clinic. Of the cases, 58.8% (n=40) had severe hypertensive diseases, whereas 35.3% of the cases (n=24) had obstetric complications that developed due to bleeding. While 40% of the cases (n=16) with hypertension had severe pre-eclampsia, 35% of the cases (n=14) had eclampsia and 25% (n=10) had HELLP. Conclusions: The most important reasons for severe maternal morbidity are the complications related to obstetric bleeding and hypertensive diseases related to pregnancy. Early diagnosis of the obstetric complication risk factors is necessary for preventing maternal morbidity. Antenatal follow-ups and the births of high risk pregnancy patients should be performed in tertiary centers